{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HS YORNOINNA","gend":0,"add":"ERCTAR 7029C TOL DR KE","city":"POUND","state":"VA","zip":"24279-9998","dob":"1977-12-10","age":"","mstatus":"","insh":"8922210*12","cliId":"","pno":"","cno":"","email":"","ename":"","eno":"","pphy":"BEVINS, ASHLEY DO","ppno":"276\/328-8910","pcpadd":"716 SPRING AVE SE SUITE 204","pcpcity":"WISE","pcpstate":"VA","pcpzip":24293,"pcpcounty":"","pcpid":"","pcpname":"","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":["K70.31","K76.6","D61.818","F10.188","K80.20","I10.","F17.210","Z79.899","K80.00","D69.6","F33.3","F10.21","R94.5","R18.8","R07.89","Z76.0","A41.9","J15.9","Q21.1","L03.311","D68.9","J44.0","R19.7","Z88.6","Z88.8","K21.9","I25.10","I25.2","M19.90","K70.30","D72.819","D64.9","R91.8","J84.09","K74.60","J44.9","G47.30","Z72.0","F51.05","Z59.0","I50.9","L03.90","J18.9","E55.9","E72.20","D50.9","F20.9","F33.2","R16.1","I86.4","B35.1","Z74.01","R41.82","J96.01","E87.2","J44.1","F10.10","K70.10","E87.6","E66.01","Z68.36","G47.33","F32.9","E80.6","R10.10","V54.12","W19.XXXD","K92.2","G47.00","N17.9","R60.1","R50.9","R60.0","Z86.79","Z01.89","R10.11","J11.1","NO DATA","F43.10","K70.0","F43.0","K29.61","D62.","K25.4","E87.70","I85.10","K52.9","J40.","I35.8","K26.4","V62.85","Z11.9","R60.9","G43.909","R55.","Z20.828","R06.02","R05.","K72.90","F32.3","Z87.11","Z87.891","E88.09","D69.59","D70.9","R50.81","R10.30","M79.642","M25.532","B34.9","F41.9","R07.9","J01.90","F41.0","F10.20","R42.","R51.","K81.0","K76.9","K92.1","I85.00","K29.60","K26.9","V62.84","I65.23","R44.3","R10.9","K29.21","K76.89","F31.9","F32.89","Z01.810","M79.89","R29.6"],"date":["2020-01-26","2020-04-27","2020-06-29","2020-01-25","2020-02-19","2020-07-27","2020-02-19","2020-01-25","2020-01-25","2020-07-27","2020-05-12","2020-04-18","2020-03-07","2020-03-07","2020-06-24","2020-03-30","2020-07-27","2020-04-14","2020-06-08","2020-04-18","2020-04-14","2020-04-14","2020-04-14","2020-04-14","2020-04-14","2020-04-14","2020-04-14","2020-04-14","2020-06-07","2020-07-27","2020-04-18","2020-07-27","2020-04-18","2020-04-18","2020-06-24","2020-06-07","2020-04-18","2020-05-12","2020-04-19","2020-04-20","2020-06-08","2020-04-19","2020-04-19","2020-04-19","2020-07-27","2020-04-19","2020-04-28","2020-04-28","2020-04-27","2020-04-27","2020-04-27","2020-05-12","2020-05-12","2020-07-27","2020-07-27","2020-07-27","2020-07-27","2020-07-27","2020-07-27","2020-07-27","2020-07-27","2020-07-27","2020-07-27","2020-07-27","2020-01-26","2020-07-20","2020-02-17","2020-04-14","2020-04-20","2020-06-07","2020-06-06","2020-06-09","2020-06-25","2020-06-25","2020-01-29","2020-02-19","2020-02-19","2020-03-02","2020-04-08","2020-03-04","2020-03-11","2020-04-04","2020-04-04","2020-04-04","2020-04-04","2020-04-04","2020-04-04","2020-04-04","2020-04-04","2020-04-04","2020-04-04","2020-04-04","2020-04-11","2020-04-11","2020-04-23","2020-05-09","2020-05-10","2020-05-09","2020-06-07","2020-06-07","2020-06-07","2020-06-07","2020-06-07","2020-06-07","2020-06-07","2020-06-07","2020-04-14","2020-02-02","2020-07-20","2020-04-04","2020-01-21","2020-01-21","2020-01-21","2020-05-12","2020-05-12","2020-06-24","2020-06-24","2020-01-24","2020-03-09","2020-04-05","2020-04-05","2020-04-05","2020-04-05","2020-05-10","2020-06-07","2020-01-29","2020-03-09","2020-04-10","2020-03-09","2020-03-09","2020-03-09","2020-04-05","2020-07-20","2020-07-20"],"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":[["","50111043401","TRAZODONE","TAB 100MG","30","Select","Select",""],["","76385011150","CARVEDILOL","TAB 6.25MG","60","Select","Select",""],["","43547030503","ARIPIPRAZOLE","TAB 15MG","30","Select","Select",""],["","14539067401","HYDROXYZ","CAP 25MG","90","Select","Select",""],["","69097083512","SERTRALINE","TAB 100MG","30","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","8","Select","Select",""],["","23155000810","HYDROCHLOROT","TAB 25MG","7","Select","Select",""],["","70954002010","PRAZOSIN","CAP 2MG","30","Select","Select",""],["","57664049983","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","57237007810","ONDANSETRON","TAB 8MG ODT","20","Select","Select",""],["","59779044870","CVS","DIS 21MG\/24H","14","Select","Select",""],["","33342025866","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","53746051401","SPIRONOLACT","TAB 50MG","60","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","00536136223","NICOTINE","GUM 2MG","220","Select","Select",""],["","24658031205","DOXYCYCL","TAB 100MG","8","Select","Select",""],["","66993068130","OLANZAPINE","TAB 5MG","30","Select","Select",""],["","00378021610","FUROSEMIDE","TAB 40MG","60","Select","Select",""],["","00603137859","LACTULOSE","SOL 10GM\/15","946","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","60","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":""}]}]}