{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GIEL-KNARFHSAH S   H","gend":1,"add":" RAGUS 6511DR RUOBRAB","city":"AXTON","state":"VA","zip":"24054-9998","dob":"2001-12-12","age":"","mstatus":"","insh":"8876110*62","cliId":"","pno":"77\/4340901-0","cno":"","email":"","ename":"","eno":"","pphy":"CRUMPTON, STEPHANIE NP","ppno":"434\/791-1345","pcpadd":"125 EXECUTIVE DRIVE SUITE H","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"DANVILLE PHYSICIAN PRACTICES LLC","plan":"OHP","program":"MEDICAID","lob":"M4","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":["F64.0","G93.0","R51.","G43.709","G44.40","M62.838","F33.41","F64.9","F33.0","F41.9","K58.9","K30.","K21.9","Z71.9","M54.2","T50.905A","F33.1","M79.675","J30.9","J45.20","G43.109","Z03.818","F41.8","J32.9","J02.9","R10.13","R10.33","R19.4","R42.","I95.9","Z76.89","Z91.030","Z78.9","H04.322","M54.81","J34.0","Z20.828","R51.9","Z20.822","J45.909","F17.210","Z88.0","Z91.040","Z79.899","K59.1","R10.84","K59.04","R12.","Z30.42","E34.8","Z51.81","Z83.2"],"date":["2021-12-14","2021-03-03","2020-06-03","2020-07-23","2020-07-07","2020-07-07","2020-11-02","2021-08-10","2021-12-14","2021-12-14","2020-03-04","2020-03-04","2020-03-04","2020-03-04","2020-08-12","2021-06-25","2020-04-28","2020-04-28","2020-04-28","2021-11-17","2020-04-28","2021-01-01","2021-12-15","2019-12-03","2019-12-03","2020-02-05","2020-02-05","2020-02-05","2020-05-02","2020-05-22","2021-11-17","2021-11-17","2021-11-17","2019-10-28","2020-07-23","2020-08-07","2021-04-21","2021-09-21","2021-09-21","2021-09-21","2021-09-21","2021-09-21","2021-09-21","2021-09-21","2019-03-14","2019-03-14","2019-03-14","2019-03-14","2020-03-16","2020-05-01","2021-08-10","2021-12-15"],"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":[["","","BENZONATATE"," BENZONATATE ","15","Select","Select",""],["","","ALIGN"," ALIGN ","30","Select","Select",""],["","","LINZESS"," LINZESS ","30","Select","Select",""],["","","BENEFIBER"," BENEFIBER ","248","Select","Select",""],["","","PROAIR"," PROAIR ","17","Select","Select",""],["","","CEFDINIR"," CEFDINIR ","20","Select","Select",""],["","","QVAR"," QVAR ","11","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","17","Select","Select",""],["","","MEDROXYPR"," MEDROXYPR ","1","Select","Select",""],["","","TALIVA"," TALIVA ","60","Select","Select",""],["","","DICYCLOMINE"," DICYCLOMINE ","90","Select","Select",""],["","","CYPROHEPTAD"," CYPROHEPTAD ","120","Select","Select",""],["","","AMOXICILLIN"," AMOXICILLIN ","20","Select","Select",""],["","","PAROXETINE"," PAROXETINE ","30","Select","Select",""],["","","FLUOCIN"," FLUOCIN ","118","Select","Select",""],["","","PANTOPRAZOLE"," PANTOPRAZOLE ","30","Select","Select",""],["","","EPIPEN"," EPIPEN ","2","Select","Select",""],["","","MONTELUKAST"," MONTELUKAST ","30","Select","Select",""],["","","HYDROXYZ"," HYDROXYZ ","100","Select","Select",""],["","","AMOX\/K"," AMOX\/K ","14","Select","Select",""],["","","DOXYCYCL"," DOXYCYCL ","20","Select","Select",""],["","","FLUOXETINE","CAP 20MG","","Select","Select",""],["","","TRAZODONE","TAB 150MG","","Select","Select",""],["","","ZOLMITRIPTAN","TAB 2.5MG","","Select","Select",""],["","","SOD","TAB 1GM","","Select","Select",""],["","","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","","RIBOFLAVIN","TAB 400MG","","Select","Select",""],["","","RIZATRIPTAN","TAB 10MG","","Select","Select",""],["","","VITAMIN","TAB 100MG","","Select","Select",""],["","","TOPIRAMATE","TAB 50MG","","Select","Select",""],["","","LAMOTRIGINE","TAB 25MG","","Select","Select",""],["","","MAG","TAB 400MG","","Select","Select",""],["","","EPINEPHRINE","INJ 0.3MG","","Select","Select",""],["","","FLUZONE","INJ 2019-20","","Select","Select",""],["","","DICLOFENAC","TAB 50MG DR","","Select","Select",""],["","","GLY-OXIDE","SOL 0.1","","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","","METHYLPRED","TAB 4MG","","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":""}]}]}