{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"J IBBOBNOSNHO","gend":1,"add":"33242 RD SEKYS 37242YAWKRAP NOTPMAHTUOS ","city":"DREWRYVILLE","state":"VA","zip":"23844-9998","dob":"1983-05-28","age":"","mstatus":"","insh":"99200210*87","cliId":"","pno":"93\/2524335-6","cno":"","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":"OHCC","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":["F25.0","F43.0","M51.36","M46.96","NO DATA","G89.29","R10.30","N39.0","M54.5","J45.909","G89.4","F41.9","M79.7","R63.5","Z71.6","F17.210","R30.0","Z11.1","E66.01","Z68.42","Z20.828","B34.9","R05.1","S00.83XA","R22.0","Z00.00","F31.89","F25.9","J44.9","Z68.39","M54.9","K04.7"],"date":["2021-03-30","2019-10-16","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2019-05-13","2021-10-01","2020-10-07","2019-03-01","2019-03-01","2019-03-01","2020-09-21","2019-03-01","2021-01-22","2021-01-22","2020-09-21","2020-09-21","2020-09-21","2020-09-21","2021-01-22","2021-01-22","2021-10-01","2019-01-15","2019-01-15","2019-02-01","2019-02-01","2019-02-01","2019-02-01","2019-02-01","2019-02-01","2020-10-07"],"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":[["","","IBUPROFEN"," IBUPROFEN ","60","Select","Select",""],["","","SYMBICORT"," SYMBICORT ","10","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","","TOPIRAMATE"," TOPIRAMATE ","90","Select","Select",""],["","","TRAZODONE"," TRAZODONE ","30","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","300","Select","Select",""],["","","CITALOPRAM"," CITALOPRAM ","30","Select","Select",""],["","","ALPRAZOLAM"," ALPRAZOLAM ","60","Select","Select",""],["","","LYRICA"," LYRICA ","60","Select","Select",""],["","","NICOTINE"," NICOTINE ","28","Select","Select",""],["","","NICODERM"," NICODERM ","28","Select","Select",""],["","","AMOXICILLIN"," AMOXICILLIN ","20","Select","Select",""],["","","KETOROLAC"," KETOROLAC ","15","Select","Select",""],["","","FLUCONAZOLE"," FLUCONAZOLE ","1","Select","Select",""],["","","ONDANSETRON"," ONDANSETRON ","15","Select","Select",""],["","","LEVOFLOXACIN"," LEVOFLOXACIN ","10","Select","Select",""],["","","PREGABALIN"," PREGABALIN ","60","Select","Select",""],["","","PREDNISONE","TAB 10MG","","Select","Select",""],["","","NABUMETONE","TAB 500MG","","Select","Select",""],["","","BUDES\/FORMOT","AER 160-4.5","","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","","MONTELUKAST","TAB 10MG","","Select","Select",""],["","","PENICILLN","TAB 500MG","","Select","Select",""],["","","PROMETHAZINE","TAB 25MG","","Select","Select",""],["","","DIAZEPAM","TAB 2MG","","Select","Select",""],["","","SMZ\/TMP","TAB 800-160","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","","ARIPIPRAZOLE","TAB 5MG","","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":""}]}]}