{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" YESDNILYLLENNOD","gend":1,"add":"CAEP 805TS EERTH","city":"EMPORIA","state":"VA","zip":"23847-9998","dob":"1987-01-02","age":"","mstatus":"","insh":"7857110*48","cliId":"","pno":"76\/2527194-8","cno":"434\/604-0742","email":"","ename":"","eno":"","pphy":"ANDERSON, MICHAEL S MD","ppno":"434\/634-6101","pcpadd":"6 DOCTORS DRIVE","pcpcity":"EMPORIA","pcpstate":"VA","pcpzip":23847,"pcpcounty":"","pcpid":"","pcpname":"EMPORIA MEDICAL ASSOCIATES PC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","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":["N91.1","O24.415","O99.413","R07.89","O99.513","R06.02","O02.1","J02.9","G43.909","Z33.1","O34.211","Z37.0","Z3A.37","Z30.2","M54.5","J30.9","R25.2","Z79.899","O99.351","R51.","O26.891","R10.12","R42.","O11.4","O72.1","O24.425","O99.214","O99.344","O10.02","Z20.822","E66.9","F41.8","O80.","D28.0","I10.","R05.1","O03.9","G43.019","F41.9","F17.200","O24.410","Z01.419","O20.0","O13.3","O34.219","Z3A.00","M25.571","J01.90","J02.0","R51.9","R21.","J20.9","O02.0","S00.03XA","F17.210","F43.23","Z72.0","E66.09","Z68.33","R00.2","Z71.6","K92.1","R10.30","R00.0","Z68.34","Z68.35"],"date":["2020-03-13","2021-04-01","2021-03-10","2021-03-10","2021-03-10","2021-03-10","2020-04-15","2021-12-27","2020-10-21","2020-10-21","2021-04-01","2021-04-01","2021-04-01","2021-04-01","2021-05-27","2021-10-15","2021-10-15","2021-12-29","2020-03-04","2020-03-04","2020-03-04","2020-03-04","2020-03-04","2021-04-01","2021-04-01","2021-04-01","2021-04-01","2021-04-01","2021-04-01","2021-04-01","2021-04-01","2021-04-01","2021-04-01","2021-07-26","2021-11-12","2021-12-29","2020-04-09","2020-08-06","2020-08-06","2020-08-06","2020-12-15","2021-07-12","2020-03-27","2021-04-01","2021-04-01","2021-04-01","2021-04-30","2021-09-22","2021-12-29","2021-12-29","2019-06-24","2019-01-28","2019-11-22","2019-12-13","2019-12-13","2019-12-13","2019-04-30","2019-09-18","2019-09-18","2019-09-18","2019-08-30","2019-08-05","2019-08-05","2019-09-04","2019-03-07","2019-04-08"],"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":[["","59762372004","ALPRAZOLAM","TAB 0.5MG","90","Select","Select",""],["","","ONE","CAP PRENATAL","","Select","Select",""],["","","METFORMIN","TAB 500MG ER","","Select","Select",""],["","50742062201","NIFEDIPINE","TAB 90MG ER","30","Select","Select",""],["","00093834301","GLYBURIDE","TAB 2.5MG","60","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","68180052001","LISINOP\/HCTZ","TAB 20-25MG","30","Select","Select",""],["","11534018701","BUT\/APAP\/CAF","CAP ","30","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","28","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","60","Select","Select",""],["","","ONETOUCH","TES ULTRA","","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","00054001825","PREDNISONE","TAB 20MG","10","Select","Select",""],["","00093221001","SUCRALFATE","TAB 1GM","40","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","68308015260","NYSTATIN","POW 100000","60","Select","Select",""],["","","ESCITALOPRAM","TAB 10MG","","Select","Select",""],["","","PROMETHAZINE","TAB 25MG","","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","14","Select","Select",""],["","71930005552","APAP\/CODEINE","TAB 300-30MG","30","Select","Select",""],["","45802048678","DOCUSATE","CAP 100MG","30","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","20","Select","Select",""],["","","TRIAMCINOLON","CRE 0.001","","Select","Select",""],["","00555901658","SPRINTEC","TAB 28 DAY","28","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","20","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","","SUMATRIPTAN","TAB 100MG","","Select","Select",""],["","","PRENATABS","TAB ","","Select","Select",""],["","","PANTOPRAZOLE","TAB 20MG","","Select","Select",""],["","","TOPIRAMATE","TAB 25MG","","Select","Select",""],["","","CONTOUR","TES NEXT","","Select","Select",""],["","","METOCLOPRAM","TAB 10MG","","Select","Select",""],["","","MECLIZINE","TAB 25MG","","Select","Select",""],["","","CULTURELLE","CHW DIGESTIV","","Select","Select",""],["","","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","","MISOPROSTOL","TAB 200MCG","","Select","Select",""],["","","CVS","TES GLUCOSE","","Select","Select",""],["","","TRUE","TES GLUCOSE","","Select","Select",""],["","","ACCU-CHEK","TES AVIVA PL","","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","13668000905","CITALOPRAM","TAB 10MG","30","Select","Select",""],["","51672404801","CLOTRIM\/BETA","CRE DIPROP","30","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":""}]}]}