{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   YMMITAZRAG L","gend":0,"add":"IR S 612LDAR REV","city":"COVINGTON","state":"VA","zip":"24426-9998","dob":"1964-07-23","age":"","mstatus":"","insh":"77200210*14","cliId":"","pno":"59\/0459055-8","cno":"540\/958-9673","email":"","ename":"","eno":"","pphy":"MONROE, JULIE DO","ppno":"540\/962-1122","pcpadd":"322 W RIVERSIDE ST","pcpcity":"COVINGTON","pcpstate":"VA","pcpzip":24426,"pcpcounty":"","pcpid":"","pcpname":"BATH COUNTY COMMUNITY HOSPITAL","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","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":["J44.1","M54.16","Z72.0","R06.03","S60.511A","R22.31","W26.0XXA","R06.02","E78.5","F17.200","J45.909","Z79.51","S51.812A","J44.9","Z23.","Z87.891","W50.0XXA","J32.9","R53.83","R07.9","Z00.00","R03.0","Z12.11","Z12.5","M54.31","Z01.00","Z20.822","J20.9","Z77.120","J96.01","I16.1","F14.120","R94.31","I73.9","M79.605","M79.604","M54.41","I10.","R00.0","F17.210","J06.9","K21.9","Z71.9","J45.901","J44.0","Z13.220","Z20.2","F17.201","U07.1","R06.00","M54.5","Z76.89","I16.0","F10.10","F19.10","Z76.0","Z88.0","Z71.6","Z09.","R06.09","Z79.82","J96.02","R41.82","R79.1","R09.02","NO DATA","F10.239","E86.0","I15.8","R33.8","Z72.89","F14.90","E66.3","J96.00","I35.8","R06.2","F41.9","Z86.16","M54.12"],"date":["2022-06-18","2019-11-08","2021-08-11","2021-07-18","2019-09-18","2019-09-18","2019-09-18","2022-07-20","2022-06-18","2022-04-19","2021-08-04","2022-06-18","2021-12-19","2022-05-09","2021-12-19","2022-07-20","2021-12-19","2019-10-03","2019-10-03","2019-11-12","2021-12-10","2020-05-18","2020-05-18","2021-12-10","2020-05-18","2020-05-18","2022-02-14","2022-07-20","2021-06-20","2022-04-22","2022-04-19","2021-08-04","2022-04-26","2022-05-16","2020-06-04","2020-06-04","2020-06-04","2022-07-20","2021-07-19","2021-07-19","2019-05-14","2022-04-19","2021-08-11","2019-07-30","2022-07-20","2021-12-10","2021-12-10","2021-12-10","2022-01-21","2022-07-28","2021-07-23","2020-03-27","2021-08-11","2021-08-11","2021-08-11","2020-03-17","2022-04-19","2021-07-18","2022-05-09","2022-06-08","2022-07-20","2022-04-22","2022-04-22","2022-04-22","2022-07-20","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-06-08","2022-06-18","2022-03-22","2022-03-22","2022-09-16"],"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":[["","","ALBUTEROL"," ALBUTEROL ","18","Select","Select",""],["","68180030360","CEFUROXIME","TAB 500MG","10","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","68382025016","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","","ADVAIR","AER 100\/50","","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","28","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","","AZITHROMYCIN"," AZITHROMYCIN ","6","Select","Select",""],["","64380071207","BENZONATATE","CAP 100MG","30","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","00378797052","IPRATROPIUM","SOL 0.02%INH","250","Select","Select",""],["","16729020201","BUSPIRONE","TAB 10MG","60","Select","Select",""],["","49483048112","ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","","WIXELA","AER 100\/50","","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","00536589688","NICOTINE","DIS 21MG\/24H","28","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","00378967130","IPRATROPIUM\/","SOL ALBUTER","270","Select","Select",""],["","","BREO","INH 100-25","","Select","Select",""],["","","FLOVENT","AER 110MCG","","Select","Select",""],["","","QVAR","AER 40MCG","","Select","Select",""],["","","FLUTIC\/SALME","AER 100\/50","","Select","Select",""],["","","CVS","DIS 21MG\/24H","","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":""}]}]}