{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"IDNACDDOT ","gend":1,"add":"EVIR 3261STH TNOMR","city":"MARTINSVILLE","state":"VA","zip":"24112-9998","dob":"1981-06-15","age":"","mstatus":"","insh":"77600210*13","cliId":"","pno":"97\/6720278-0","cno":"276\/790-8720","email":"","ename":"","eno":"","pphy":"CARTER, JOANNA NP","ppno":"276\/956-2233","pcpadd":"4944 GREENSBORO ROAD","pcpcity":"RIDGEWAY","pcpstate":"VA","pcpzip":24148,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"","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":["Z03.818","Q79.0","E66.01","Z68.43","N87.1","Z32.02","K04.7","R11.0","Z71.89","Z71.3","R10.2","Z11.3","N93.8","N76.0","N39.0","R00.0","R87.810","Z01.810","D49.89","I10.","D06.7","K21.9","E03.9","E78.00","G40.909","E66.9","F17.210","N87.9","R32.","R56.9","S23.41XA","S70.01XA","Z68.42","Z72.0","D72.829","G47.00","G62.9","K08.89","F41.8","D06.0","E78.5","D06.9","N93.9","N99.820","R11.2","R19.7","K05.10","K13.79","F17.219","R63.5","R05.","F41.9","N92.4","N91.2","R79.9","M54.5","B37.3","Z71.6"],"date":["2021-06-07","2021-12-22","2021-12-22","2021-12-22","2022-04-28","2022-04-28","2022-05-19","2022-05-19","2022-09-21","2022-09-21","2021-09-10","2021-09-02","2021-12-25","2021-09-02","2021-09-10","2021-09-10","2021-09-13","2021-11-17","2021-11-17","2022-09-21","2021-12-02","2021-12-02","2022-09-21","2021-12-02","2021-12-02","2021-12-02","2021-12-29","2021-12-02","2022-02-09","2022-03-14","2022-08-02","2022-08-02","2022-09-21","2022-08-02","2022-09-21","2022-09-21","2022-09-21","2020-10-13","2021-07-27","2021-12-02","2022-02-17","2021-12-02","2021-12-25","2021-12-25","2022-01-26","2022-01-26","2020-07-24","2020-07-24","2020-07-24","2020-07-24","2021-06-07","2021-07-16","2021-09-09","2021-09-09","2021-09-09","2021-09-10","2021-10-27","2021-12-29"],"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":[]},{"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":[["","00378728053","NORETH\/ETHIN","TAB 44581","21","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","42","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","13668000805","ZOLPIDEM","TAB 10MG","30","Select","Select",""],["","00093226301","AMOXICILLIN","TAB 500MG","21","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","69842090001","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00378180310","LEVOTHYROXIN","TAB 50MCG","30","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","71930005552","APAP\/CODEINE","TAB 300-30MG","18","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","28","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","65162021211","PHENYTOIN","CAP 100MG","90","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","20","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","28","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","00904631256","COUGH","SUS 30MG\/5ML","89","Select","Select",""],["","73302045601","ELLA","TAB 30MG","2","Select","Select",""],["","50428016183","CVS","CAP 2000UNIT","60","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","50742061610","METOPROL","TAB 50MG ER","60","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","50228014610","HYDROCHLOROT","CAP 12.5MG","30","Select","Select",""],["","70377002711","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","00904052380","VITAMIN","TAB 500MG","60","Select","Select",""],["","50428042388","MELATONIN","CAP 10MG","30","Select","Select",""],["","00731040106","ZINC-220","CAP ","90","Select","Select",""],["","59762372004","ALPRAZOLAM","TAB 0.5MG","30","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","80681000200","ZINC","TAB 50MG","90","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00536589688","NICOTINE","DIS 21MG\/24H","28","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","10","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","70436001002","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","70700016406","LEVONORGESTR","TAB 1.5MG","8","Select","Select",""],["","61783000012","FC2","MIS CONDOM","96","Select","Select",""],["","31722057230","ESOMEPRA","CAP 20MG DR","30","Select","Select",""],["","00093081101","NORTRIPTYLIN","CAP 25MG","90","Select","Select",""],["","69097085902","TERBINAFINE","TAB 250MG","30","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","14","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00093117410","PENICILLN","TAB 500MG","28","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":""}]}]}