{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   EIRAMSIVAD L","gend":1,"add":"W 05221NL ESI","city":"ABINGDON","state":"VA","zip":"24210-9998","dob":"1960-04-17","age":"","mstatus":"","insh":"26200210*76","cliId":"","pno":"76\/6724113-6","cno":"","email":"","ename":"","eno":"","pphy":"DOCKERY, ELIZABETH J DO","ppno":"276\/628-1186","pcpadd":"STE 300 613 CAMPUS DR","pcpcity":"ABINGDON","pcpstate":"VA","pcpzip":24210,"pcpcounty":"","pcpid":"","pcpname":"ABINGDON PHYSICIAN PARTNERS","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","M54.5","J18.9","R53.81","R53.1","R06.02","R74.8","R53.83","Z23.","E53.8","F33.0","NO DATA","K21.9","Z12.31","E78.2","G89.29","J40.","R05.","R09.81","Z12.11","R50.9","B34.9","E87.6","M51.35","R79.89","M25.551","F10.20","M25.552","J01.01","J20.9","K04.7","F17.220","H25.812","F32.9","Z96.1","H25.042","H26.491"],"date":["2022-01-06","2021-06-03","2021-07-20","2021-07-20","2021-07-20","2022-01-06","2021-07-20","2021-07-20","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2020-01-21","2021-07-11","2021-06-03","2021-06-03","2021-07-11","2021-07-11","2021-07-13","2021-07-18","2021-07-18","2020-12-03","2020-12-03","2020-12-03","2020-01-08","2020-01-08","2019-02-19","2019-08-27","2019-05-08","2019-08-27","2019-02-06","2019-02-06","2019-02-06"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","68180051902","LISINOP\/HCTZ","TAB 20-12.5","90","Select","Select",""],["","69097084615","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","","IBUPROFEN","TAB 600MG","","Select","Select",""],["","00904421713","VITAMIN","TAB 1000MCG","30","Select","Select",""],["","00093720298","PRAVASTATIN","TAB 40MG","30","Select","Select",""],["","68462039710","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","13668001005","CITALOPRAM","TAB 20MG","30","Select","Select",""],["","","VENTOLIN","AER ","","Select","Select",""],["","69557011101","ZTLIDO","PAD 0.018","30","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","","BENZONATATE","CAP 200MG","","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","59762306001","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","43386091710","POT  CHLORIDE","TAB 20MEQ ER","20","Select","Select",""],["","","LEVOFLOXACIN","TAB 500MG","","Select","Select",""],["","60505011308","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","","PROMETHAZINE","SYP DM","","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","60","Select","Select",""],["","","NARCAN","SPR ","","Select","Select",""],["","66685100101","AMOX\/K","TAB 875-125","20","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}