{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ELLEHCIMZTUL L  ","gend":1,"add":"R DEKOORC 1333401 TPA DR NU","city":"MOUNT JACKSON","state":"VA","zip":"22842-9998","dob":"1982-08-09","age":"","mstatus":"","insh":"4362110*05","cliId":"","pno":"42\/0452990-4","cno":"","email":"","ename":"","eno":"","pphy":"SWITZER, DAVID MD","ppno":"540\/843-4624","pcpadd":"STE B 250 MEMORIAL DRIVE","pcpcity":"LURAY","pcpstate":"VA","pcpzip":22835,"pcpcounty":"","pcpid":"","pcpname":"PAGE MEMORIAL HOSPITAL INC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"NORTHERN & WINCHESTER","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":["N30.01","Z87.01","J30.2","Z87.442","J45.40","R59.0","J98.4","Z23.","M79.674","H60.512","H66.92","H92.02","R07.9","B35.1","L98.9","J34.0","R10.13","R19.7","M54.9","R91.8","L72.9","M25.552","R22.0","L02.31","L60.0","L08.89","L03.032","M79.675","N64.4","K21.9","Z01.419","Z12.4","R30.0","M54.6","R31.9","NO DATA","R07.2","R10.9","N76.0","J40.","R39.15","I08.1","R94.31","U07.1","J96.01","D68.69","T80.1XXA","E87.3","I80.8","A49.02","J45.909","F41.9","E87.6","D72.829","R79.82","R79.89","Z86.14","F41.8","N83.202","J11.1","R06.02","R50.9","R53.83","R11.2","R05.9","B34.9","L03.211","B95.62","Z22.322","J06.9","R07.89","Z20.822","R11.0","I80.01","R07.81"],"date":["2020-09-24","2020-09-24","2021-02-16","2020-09-24","2021-02-16","2020-09-24","2021-02-16","2020-12-28","2020-12-28","2021-03-19","2021-03-19","2021-03-19","2021-04-06","2019-06-11","2019-06-11","2021-12-13","2020-07-11","2022-01-09","2020-07-11","2020-07-11","2021-09-10","2021-09-10","2022-04-09","2019-02-24","2019-06-24","2019-06-24","2019-06-24","2019-06-24","2021-02-23","2021-02-16","2020-09-01","2019-08-27","2019-09-03","2019-09-03","2022-01-21","2022-01-21","2021-03-01","2022-05-04","2019-10-10","2022-01-06","2019-11-12","2021-03-16","2021-03-16","2022-01-21","2022-01-19","2022-01-09","2022-01-09","2022-01-09","2022-01-19","2022-01-09","2022-01-09","2022-01-09","2022-01-19","2022-01-19","2022-01-09","2022-01-09","2022-01-09","2022-01-19","2022-05-04","2022-01-09","2022-01-09","2022-01-09","2022-01-09","2022-01-09","2022-04-18","2022-01-01","2022-04-09","2022-04-09","2022-04-09","2022-04-18","2022-04-18","2022-04-18","2022-01-06","2022-01-21","2022-01-19"],"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":[["","24658031205","DOXYCYCL","TAB 100MG","14","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","5","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","70710113803","FLUCONAZOLE","TAB 100MG","7","Select","Select",""],["","67877054360","CEFDINIR","CAP 300MG","20","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","30","Select","Select",""],["","","SMZ\/TMP"," SMZ\/TMP ","20","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","23","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","00069034530","PAXLOVID","TAB 300-100","30","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","40","Select","Select",""],["","00054418125","DEXAMETHASON","TAB 1MG","15","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","23","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","180","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","","WIXELA","AER 250\/50","","Select","Select",""],["","","MONTELUKAST","TAB 10MG","","Select","Select",""],["","24208063562","NEO\/POLY\/HC","SUS 1% OTIC","10","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","00173068220","VENTOLIN","AER ","7","Select","Select",""],["","63304061650","DOXYCYC","CAP 100MG","20","Select","Select",""],["","","FLOVENT","AER 110MCG","","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":""}]}]}