{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANITSIRHCODIDNAC ","gend":1,"add":"DOOW 102RD ENOTS","city":"BIG STONE GAP","state":"VA","zip":"24219-9998","dob":"1990-08-23","age":"","mstatus":"","insh":"4823210*81","cliId":"","pno":"47\/7399978-9","cno":"","email":"","ename":"","eno":"","pphy":"DELLA VECCHIA, JASON J MD","ppno":"423\/434-6677","pcpadd":"SUITE 4 2408 SUSANNAH STREET","pcpcity":"JOHNSON CITY","pcpstate":"TN","pcpzip":37601,"pcpcounty":"","pcpid":"","pcpname":"EAST TENNESSEE RECOVERY PLLC","plan":"OHP","program":"MEDICAID","lob":"M4","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":["I38.","I10.","F17.200","Z79.01","Z68.39","Z3A.32","N17.9","O26.893","R03.0","Z3A.36","O99.213","E66.8","O14.93","O99.333","Z01.812","Z30.430","Z30.46","F11.20","F32.2","F51.01","NO DATA","F41.9","Z72.0","Z86.79","R10.30","K59.00","G62.9","N92.1","Z30.09","Z97.5","O80.","Z30.017","L98.0","L53.8","R20.8","O11.4","O98.42","Z37.0","O10.22","O99.824","I12.9","O40.3XX0","O76.","I07.9","B18.2","N18.9","O99.334","B95.1","Z86.718","O99.322","Z23.","I36.1","I51.7","I31.3","O75.89","I33.0","O12.13","O99.214","S39.012A","X50.0XXA","D18.01","N91.2","Z30.431","T83.9XXA","Z53.21","K08.89"],"date":["2020-12-22","2021-12-28","2020-12-22","2020-11-24","2020-11-24","2020-11-24","2020-11-24","2020-12-22","2020-12-22","2020-12-23","2020-12-22","2020-12-23","2020-12-22","2020-12-22","2021-06-18","2021-08-12","2021-06-18","2021-12-28","2021-12-14","2021-12-28","2021-12-28","2021-12-14","2021-12-14","2021-12-14","2021-12-12","2021-12-12","2021-12-14","2021-05-05","2021-05-05","2021-05-05","2020-12-22","2020-12-25","2021-09-01","2021-09-01","2021-09-01","2020-12-23","2020-12-22","2020-12-23","2020-12-22","2020-12-22","2020-12-22","2020-12-23","2020-12-22","2020-12-22","2020-12-22","2020-12-22","2020-12-22","2020-12-22","2020-12-22","2020-10-23","2020-10-23","2020-12-22","2020-12-22","2020-12-22","2020-12-23","2020-12-23","2020-12-23","2020-12-23","2021-05-10","2021-05-10","2021-08-03","2021-08-03","2021-08-03","2021-08-03","2021-12-12","2021-12-12"],"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":[["","00093506201","HYDROXYZ","TAB 50MG","120","Select","Select",""],["","69102013710","LAMOTRIGINE","KIT START 49","49","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","28","Select","Select",""],["","00378876793","BUPREN\/NALOX","MIS 8-2MG","56","Select","Select",""],["","68462012705","GABAPENTIN","TAB 800MG","42","Select","Select",""],["","","IBUPROFEN","TAB 600MG","","Select","Select",""],["","10702000709","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","10","Select","Select",""],["","00093719801","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","00363023820","STOOL","CAP 100MG","30","Select","Select",""],["","00591207030","LIDO\/PRILOCN","CRE 2.5-2.5%","30","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","00115165901","PROPRANOLOL","TAB 10MG","21","Select","Select",""],["","33342006807","OLANZAPINE","TAB 5MG","7","Select","Select",""],["","16729044315","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","00093083205","CLONAZEPAM","TAB 0.5MG","16","Select","Select",""],["","00093224001","CEPHALEXIN","TAB 500MG","20","Select","Select",""],["","","NIFEDIPINE","TAB 30MG ER","","Select","Select",""],["","","ENOXAPARIN","INJ 40\/0.4ML","","Select","Select",""],["","","OMEPRAZOLE","CAP 20MG","","Select","Select",""],["","","LABETALOL","TAB 100MG","","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":""}]}]}