{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AMANDA   A COOTS","gend":1,"add":"PO BOX 144","city":"WISE                          ","state":"VA","zip":"24293-9998","dob":"1986-06-25","age":"","mstatus":"","insh":3230888,"cliId":"","pno":2762988452,"cno":"","email":"","ename":"","eno":"","pphy":"AKINS, MEGAN","ppno":4233926200,"pcpadd":"105 W Stone Dr Ste V,","pcpcity":"Kingsport                     ","pcpstate":"TN","pcpzip":376603256,"pcpcounty":"","pcpid":"","pcpname":"HOLSTON MEDICAL GROUP PC","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"SOUTHWEST","aligned":"","ano":"","add2":"PO BOX 144","add3":"","madd1":"PO BOX 144","madd2":"APT B","madd3":"","mcity":"WISE                          ","mstate":"VA","mzip":"24293-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N18.5","D64.9","I95.1","I10","R80.9","E55.9","E11.21","R68.89","S82.852D","M25.572","Z01.812","E10.65","N18.6","Z99.2","E11.40","E10.9","E66.09","Z68.32","E03.9","Z47.89","R60.9","E87.70","E10.29","F41.9","F32.9","M62.838","H43.13","E10.3513","E10.3531","N25.81","N18.4","E10.21","M25.512","G47.00","Z23","D63.1","E11.621","L97.509","M75.02","R80.1","E11.3553","H25.813","H21.561","L89.90","L89.892","L97.511","N17.9","E87.6","N19","Z20.822","I12.0","E46","E87.1","E10.22","E10.3213","E10.42","E83.39","G25.81","J98.11","R39.2","L29.9","R10.12","F33.0","R06.02","T82.49XA","T82.590A","Y71.2","I87.1","N04.9","E10.40","T82.858A","M89.9","E83.50","E83.59","E83.30","K04.7","R11.2","E11.22","Z78.9","X58.XXXA","Z79.4","Z98.62","U07.1","N18.9","E66.3","R05","Z79.899","F41.1","S90.821A","Z86.16","Z95.828","D50.9"],"date":["2021-04-12","2021-04-13","2020-05-21","2021-04-13","2021-04-13","2021-04-13","2020-05-21","2020-01-09","2020-05-12","2020-02-11","2020-02-13","2021-06-25","2021-12-29","2021-12-29","2021-06-25","2021-09-24","2020-03-13","2020-03-13","2021-08-09","2020-05-12","2020-05-21","2020-09-23","2020-06-22","2021-10-18","2021-10-18","2020-06-10","2020-06-30","2020-06-30","2020-06-30","2021-12-01","2021-04-03","2021-05-01","2021-02-01","2020-09-23","2021-07-01","2021-12-01","2021-04-06","2020-12-10","2021-02-01","2021-04-12","2021-01-25","2021-01-25","2021-01-25","2021-03-18","2021-04-06","2021-04-06","2021-08-27","2021-04-13","2021-04-12","2021-04-26","2021-12-29","2021-12-01","2021-04-13","2021-10-18","2021-04-26","2021-04-12","2021-04-13","2021-04-12","2021-04-12","2021-04-13","2021-04-13","2021-04-12","2021-04-13","2021-04-26","2021-04-26","2021-08-09","2021-04-26","2021-04-26","2021-04-26","2021-04-27","2021-08-09","2021-07-01","2021-08-03","2021-08-03","2021-08-03","2021-05-28","2021-06-25","2021-12-29","2021-08-27","2021-08-09","2021-08-09","2021-08-09","2021-09-16","2021-09-09","2021-09-09","2021-09-16","2021-10-18","2021-09-24","2021-10-10","2021-10-18","2021-10-18","2021-12-01"],"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":[["","68382004101","PROMETHAZINE","TAB 25MG","25","Select","Select",""],["","00169750111","NOVOLOG","INJ 100\/ML","10","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","60","Select","Select",""],["","50228018105","GABAPENTIN","CAP 400MG","90","Select","Select",""],["","33342009441","RIZATRIPTAN","TAB 10MG ODT","10","Select","Select",""],["","55111017915","TIZANIDINE","TAB 2MG","30","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","2","Select","Select",""],["","00781552831","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","00169406013","VICTOZA","INJ 18MG\/3ML","9","Select","Select",""],["","81131038679","RELION","MIS 32GX4MM","100","Select","Select",""],["","60505009400","DOXAZOSIN","TAB 2MG","30","Select","Select",""],["","00603548221","PROPRANOLOL","TAB 10MG","180","Select","Select",""],["","68645055154","LISINOPRIL","TAB 5MG","15","Select","Select",""],["","00088222033","LANTUS","INJ 100\/ML","10","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","00904675180","ASPIRIN","TAB 81MG EC","42","Select","Select",""],["","68645013054","FLUOXETINE","CAP 20MG","270","Select","Select",""],["","50111091801","TORSEMIDE","TAB 100MG","60","Select","Select",""],["","50111043301","TRAZODONE","TAB 50MG","30","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","47781064690","LEVOTHYROXIN","TAB 75MCG","90","Select","Select",""],["","31722070190","LOSARTAN","TAB 50MG","30","Select","Select",""],["","72305007530","EUTHYROX","TAB 75MCG","30","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","65862017260","TOPIRAMATE","TAB 50MG","60","Select","Select",""],["","49035007860","EQ","CAP SOFTENER","60","Select","Select",""],["","54629060099","DOCUSATE","CAP 100MG","60","Select","Select",""],["","81131031174","INSULIN","MIS 1ML\/31G","100","Select","Select",""],["","57599000200","FREESTYLE    MIS READER","MIS READER","1","Select","Select",""],["","59651036205","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","80777027310","MODERNA","INJ COVID-19","0.5","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","14","Select","Select",""],["","00185560001","METOLAZONE","TAB 10MG","30","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","00904645780","DOK","CAP 100MG","60","Select","Select",""],["","00832532511","POT  CL MICRO","TAB 20MEQ ER","32","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","9","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","30","Select","Select",""],["","75834002001","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","00093735301","CALCITRIOL","CAP 0.5MCG","12","Select","Select",""],["","13668022030","ARIPIPRAZOLE","TAB 20MG","30","Select","Select",""],["","60505024801","MIRTAZAPINE","TAB 30MG","30","Select","Select",""],["","69315090410","LORAZEPAM","TAB 0.5MG","10","Select","Select",""],["","00574060810","FERROUS","TAB 324MG EC","90","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","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":""}]}]}