{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN   H WEBB JR","gend":0,"add":"462 STONE HOLW","city":"CLINTWOOD","state":"VA","zip":"24228-9998","dob":"1964-06-23","age":"","mstatus":"","insh":"20037083*01","cliId":"","pno":"276\/926-4539","cno":"276\/926-4539","email":"","ename":"","eno":"","pphy":"NEWBERRY, BRIAN S DO","ppno":"276\/679-8890","pcpadd":"96 15TH ST NW SUITE 104","pcpcity":"NORTON","pcpstate":"VA","pcpzip":24273,"pcpcounty":"","pcpid":152191,"pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"276\/679-9740","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.65","I10.","E11.49","G25.81","M25.561","M25.562","H10.232","L03.317","E11.00","Z79.4","E11.9","M54.9","E66.01","G89.29","L98.491","L02.31","J20.9","L02.91","NO DATA","E08.00","S05.90XA","B37.9"],"date":["2020-07-20","2020-12-21","2021-09-13","2020-11-16","2021-09-13","2021-09-13","2021-07-08","2021-02-19","2021-05-17","2021-09-13","2021-09-13","2021-09-13","2021-01-07","2021-01-07","2021-05-03","2020-12-21","2020-11-16","2020-12-21","2021-05-03","2021-09-13","2021-05-03","2021-09-13"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"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":[]}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","31722070110","LOSARTAN ","50MG","30","Select","Select",""],["","62175089143","ATORVASTATIN ","20MG","30","Select","Select",""],["","08222710093","PEN  NEEDLES  ","31GX8MM","120","Select","Select",""],["","64980041409","PREGABALIN ","150MG","60","Select","Select",""],["","00088222033","LANTUS ","100\/ML","50","Select","Select",""],["","56151173301","INSULIN ","1ML\/31G","60","Select","Select",""],["","00115146845","LIDO\/PRILOCN ","2.5-2.5%","480","Select","Select",""],["","00169633910","NOVOLOG ","FLEXPEN","15","Select","Select",""],["","53885000810","ONETOUCH ","PLUS 33G","91","Select","Select",""],["","69315030660","NYSTATIN ","100000","60","Select","Select",""],["","29300012401","MELOXICAM ","7.5MG","30","Select","Select",""],["","00169406013","VICTOZA ","18MG\/3ML","9","Select","Select",""],["","68462025601","ROPINIROLE ","2MG","30","Select","Select",""],["","43547039711","HYDROCHLOROT ","25MG","30","Select","Select",""],["","67877019810","AMLODIPINE ","5MG","30","Select","Select",""],["","00597015330","JARDIANCE ","25MG","30","Select","Select",""],["","63868087120","MUCUS ","600MG ER","20","Select","Select",""],["","63824000840","MUCINEX ","600MG ER","20","Select","Select",""],["","11917006877","BLOOD ","MANUAL","1","Select","Select",""],["","33342002332","LEVOFLOXACIN ","750MG","10","Select","Select",""],["","27808003503","HYDROCO\/APAP ","5-325MG","28","Select","Select",""],["","53489014601","SMZ\/TMP ","800-160","20","Select","Select",""],["","42571025201","CLINDAMYCIN ","300MG","30","Select","Select",""],["","24208083060","NEO\/POLY\/DEX ","0.1% OP","5","Select","Select",""],["","60758018805","GENTAMICIN ","0.3% OP","5","Select","Select",""],["","27241011403","TADALAFIL ","20MG","15","Select","Select",""],["","65862020299","LOSARTAN","50MG","30","Select","Select",""],["","56151173301","INSULIN","1ML\/31G","60","Select","Select",""],["","00088222033","LANTUS","100\/ML","30","Select","Select",""],["","29300012401","MELOXICAM","7.5MG","30","Select","Select",""],["","00169633910","NOVOLOG","FLEXPEN","15","Select","Select",""],["","27241011403","TADALAFIL","20MG","15","Select","Select",""],["","53885000810","ONETOUCH","PLUS 33G","91","Select","Select",""],["","69315030660","NYSTATIN","100000","60","Select","Select",""],["","64980041409","PREGABALIN","150MG","60","Select","Select",""],["","00115146845","LIDO\/PRILOCN","2.5-2.5%","480","Select","Select",""],["","00169406013","VICTOZA","18MG\/3ML","9","Select","Select",""],["","62175089143","ATORVASTATIN","20MG","30","Select","Select",""],["","08222710093","PEN NEEDLES","31GX8MM","120","Select","Select",""],["","43547027110","ROPINIROLE","2MG","30","Select","Select",""],["","43547039711","HYDROCHLOROT","25MG","30","Select","Select",""],["","67877019810","AMLODIPINE","5MG","30","Select","Select",""],["","00597015330","JARDIANCE","25MG","30","Select","Select",""],["","63868087120","MUCUS","600MG ER","20","Select","Select",""],["","63824000840","MUCINEX","600MG ER","20","Select","Select",""],["","11917006877","BLOOD","MANUAL","1","Select","Select",""],["","27808003503","HYDROCO\/APAP","5-325MG","28","Select","Select",""],["","42571025201","CLINDAMYCIN","300MG","30","Select","Select",""],["","53489014601","SMZ\/TMP","800-160","20","Select","Select",""],["","24208083060","NEO\/POLY\/DEX","0.1% OP","5","Select","Select",""],["","60758018805","GENTAMICIN","0.3% OP","5","Select","Select",""],["","0","","","60","Select","Select",""],["","33342002332","LEVOFLOXACIN","750MG","10","Select","Select",""],["","00024576105","SOLIQUA ","INJ 100\/33","3","Select","Select",""],["","00169368712","LEVEMIR ","INJ ","50","Select","Select",""],["","00002143480","TRULICITY ","INJ 1.5\/0.5","2","Select","Select",""],["","00002879959","HUMALOG ","INJ 100\/ML","15","Select","Select",""],["","00169320415","FIASP ","INJ TOUCH","15","Select","Select",""],["","00169413212","OZEMPIC ","INJ 2\/1.5ML","2","Select","Select",""],["","00310654004","BYDUREON ","INJ 2\/0.85ML","3","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}