{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  YENTIHWSETAY T ","gend":1,"add":"OB OP246 X","city":"HONAKER","state":"VA","zip":"24260-9998","dob":"2000-11-21","age":"","mstatus":"","insh":"9385110*73","cliId":"","pno":"79\/6729003-1","cno":"","email":"","ename":"","eno":"","pphy":"HARMAN, NICHOLAS DO","ppno":"276\/889-3700","pcpadd":"495 EAST MAIN ST","pcpcity":"LEBANON","pcpstate":"VA","pcpzip":24266,"pcpcounty":"","pcpid":"","pcpname":"HOLSTON MEDICAL GROUP PC","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":["Z39.1","Z34.82","Z34.83","M79.605","F41.9","J45.909","M54.5","Z53.21","O62.0","O98.82","B95.1","Z3A.39","Z37.0","O80.","M53.3","F32.1","F41.1","J45.30","O90.0","O99.335","F17.210","L76.22","U07.1","Z20.822","J34.89","O99.512","J06.9","B34.9","Z3A.19","D64.89","O61.8","O66.40","R53.83","R35.0","G89.18","Z48.02","T78.40XA"],"date":["2019-07-09","2019-07-09","2019-07-09","2019-09-13","2021-07-15","2020-04-01","2021-07-15","2021-07-15","2019-08-06","2019-08-06","2019-08-06","2019-08-06","2019-08-06","2019-08-06","2021-09-29","2019-03-01","2021-08-30","2019-03-01","2019-08-19","2019-08-16","2019-08-16","2019-08-16","2021-09-08","2021-09-08","2021-09-08","2019-03-17","2019-03-17","2019-03-17","2019-03-17","2019-08-30","2019-08-06","2019-08-06","2019-08-14","2019-08-14","2019-08-14","2019-08-14","2021-02-19"],"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":[["","","VENTOLIN"," VENTOLIN ","18","Select","Select",""],["","","PREPLUS"," PREPLUS ","30","Select","Select",""],["","","AMPICILLIN"," AMPICILLIN ","40","Select","Select",""],["","","ALPRAZOLAM"," ALPRAZOLAM ","60","Select","Select",""],["","","TERCONAZOLE"," TERCONAZOLE ","45","Select","Select",""],["","","OXYCOD\/APAP"," OXYCOD\/APAP ","30","Select","Select",""],["","","DOCUSATE"," DOCUSATE ","60","Select","Select",""],["","","HEMOCYTE"," HEMOCYTE ","30","Select","Select",""],["","","CEFUROXIME"," CEFUROXIME ","20","Select","Select",""],["","","LEVOFLOXACIN"," LEVOFLOXACIN ","10","Select","Select",""],["","","SMZ-TMP"," SMZ-TMP ","20","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","30","Select","Select",""],["","","SPRINTEC"," SPRINTEC ","28","Select","Select",""],["","","CITALOPRAM"," CITALOPRAM ","30","Select","Select",""],["","","PROVENTIL"," PROVENTIL ","7","Select","Select",""],["","","SERTRALINE","TAB 25MG","","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","","PERMETHRIN","LOT 0.01","","Select","Select",""],["","","NIX","LIQ 0.01","","Select","Select",""],["","","MONTELUKAST","TAB 10MG","","Select","Select",""],["","","ALBUTEROL","AER HFA","","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":""}]}]}