{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CORTNEY   M METCALF","gend":1,"add":"19149 TOMLIN HILL DR ZUNI VA 23898","city":"ZUNI","state":"VA","zip":"23898-9998","dob":"1985-07-13","age":"","mstatus":"","insh":"9472177*01","cliId":"","pno":"757\/509-4648","cno":"757\/509-4648","email":"","ename":"","eno":"","pphy":"ANDERSON, MICHAEL S MD","ppno":"434\/634-6101","pcpadd":"6 DOCTORS DRIVE","pcpcity":"EMPORIA","pcpstate":"VA","pcpzip":23847,"pcpcounty":"","pcpid":104763,"pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","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":["N94.9","R10.11","Z20.828","K76.0","K59.00","Z87.59","R42.","N80.9","G43.009","R55.","F43.12","F32.2","G47.00","D51.0","Z87.898","D64.9","Z68.42","J32.9","R07.9","R06.02","R60.0","I10.","I51.7","R60.1","F32.0","F41.1","Z91.410","Z91.411","J32.0","J32.1","J32.2","J32.3","J01.91","F41.9","F32.9","Z63.0","M54.42","M54.41","G89.29","M72.2","M67.00","M25.571","M25.572","Z68.43","U07.1","R07.89","D50.9","R60.9"],"date":["2020-02-18","2020-02-24","2020-12-14","2020-02-24","2020-05-07","2020-05-07","2020-12-21","2020-02-27","2020-03-23","2021-04-26","2021-09-21","2021-09-21","2021-09-21","2021-06-03","2021-06-03","2021-06-03","2021-05-05","2020-05-26","2020-03-11","2020-03-24","2020-03-11","2020-03-24","2020-03-24","2020-03-24","2021-04-06","2021-04-06","2021-04-06","2021-04-06","2020-05-08","2020-05-08","2020-05-08","2020-05-08","2020-05-08","2020-05-19","2020-05-19","2020-05-19","2020-05-21","2020-05-21","2020-06-08","2020-06-08","2020-06-08","2020-06-08","2020-06-08","2021-06-03","2020-12-28","2021-04-02","2021-06-03","2020-02-19"],"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":[["","00093770198","LEVOCETIRIZI ","5MG","30","Select","Select",""],["","13668013601","ESCITALOPRAM ","10MG","30","Select","Select",""],["","00378180010","LEVOTHYROXIN ","25MCG","30","Select","Select",""],["","67877026218","RIZATRIPTAN ","10MG","9","Select","Select",""],["","68180051303","LISINOPRIL ","5MG","30","Select","Select",""],["","69452015120","VITAMIN ","50000UNT","4","Select","Select",""],["","50111043301","TRAZODONE ","50MG","30","Select","Select",""],["","00591578301","ATENOL\/CHLOR ","100-25MG","30","Select","Select",""],["","55513084101","AIMOVIG ","70MG\/ML","1","Select","Select",""],["","64380080307","RANITIDINE ","150MG","30","Select","Select",""],["","40093010209","MAG ","500MG","30","Select","Select",""],["","70069000510","CYANOCOBALAM ","1000MCG","2","Select","Select",""],["","23155000810","HYDROCHLOROT ","25MG","30","Select","Select",""],["","62175061743","PANTOPRAZOLE ","40MG","30","Select","Select",""],["","16571020210","DICLOFENAC ","50MG DR","60","Select","Select",""],["","53746010901","HYDROCO\/APAP ","5-325MG","10","Select","Select",""],["","65162006205","SUCRALFATE ","1GM\/10ML","200","Select","Select",""],["","16729020001","BUSPIRONE ","5MG","30","Select","Select",""],["","00378020810","FUROSEMIDE ","20MG","10","Select","Select",""],["","65162047505","NORETHIN ","5MG","30","Select","Select",""],["","00054327099","FLUTICASONE ","50MCG","16","Select","Select",""],["","00093220305","METOCLOPRAM ","10MG","20","Select","Select",""],["","70710113908","FLUCONAZOLE ","150MG","2","Select","Select",""],["","00228202950","ALPRAZOLAM ","0.5MG","30","Select","Select",""],["","71858001004","TIROSINT ","25MCG","30","Select","Select",""],["","69097015907","MELOXICAM ","15MG","30","Select","Select",""],["","67877032105","IBUPROFEN ","800MG","30","Select","Select",""],["","0","","","60","Select","Select",""],["","69097081312","GABAPENTIN ","100MG","90","Select","Select",""],["","69097084615","CYCLOBENZAPR ","10MG","90","Select","Select",""],["","65862050320","AMOX\/K ","875-125","20","Select","Select",""],["","00456111030","VIIBRYD ","10MG","30","Select","Select",""],["","65862053750","LEVOFLOXACIN ","500MG","10","Select","Select",""],["","68180016106","AZITHROMYCIN ","500MG","3","Select","Select",""],["","69097012303","TOPIRAMATE ","50MG","30","Select","Select",""],["","43598072101","HYDROXYCHLOR ","200MG","28","Select","Select",""],["","42799080601","IVERMECTIN ","3MG","9","Select","Select",""],["","65862001501","AMOXICILLIN ","875MG","20","Select","Select",""],["","59267100002","PFIZER ","COVID-19","0","Select","Select",""],["","65862007701","CIPROFLOXACN ","500MG","10","Select","Select",""],["","49884072501","BUSPIRONE","7.5MG","30","Select","Select",""],["","00378180010","LEVOTHYROXIN","25MCG","30","Select","Select",""],["","50111043301","TRAZODONE","50MG","30","Select","Select",""],["","70069000510","CYANOCOBALAM","1000MCG","2","Select","Select",""],["","23155000810","HYDROCHLOROT","25MG","30","Select","Select",""],["","69452015120","VITAMIN","50000UNT","4","Select","Select",""],["","62175061743","PANTOPRAZOLE","40MG","30","Select","Select",""],["","00093770198","LEVOCETIRIZI","5MG","30","Select","Select",""],["","64380080307","RANITIDINE","150MG","30","Select","Select",""],["","40093010209","MAG","500MG","30","Select","Select",""],["","13668013601","ESCITALOPRAM","10MG","30","Select","Select",""],["","00054327099","FLUTICASONE","50MCG","16","Select","Select",""],["","55513084101","AIMOVIG","70MG\/ML","1","Select","Select",""],["","00591578301","ATENOL\/CHLOR","100-25MG","30","Select","Select",""],["","67877026218","RIZATRIPTAN","10MG","9","Select","Select",""],["","68180051303","LISINOPRIL","5MG","30","Select","Select",""],["","16571020210","DICLOFENAC","50MG DR","60","Select","Select",""],["","00378020810","FUROSEMIDE","20MG","10","Select","Select",""],["","53746010901","HYDROCO\/APAP","5-325MG","10","Select","Select",""],["","65162006205","SUCRALFATE","1GM\/10ML","200","Select","Select",""],["","00093220305","METOCLOPRAM","10MG","20","Select","Select",""],["","65162047505","NORETHIN","5MG","90","Select","Select",""],["","71858001004","TIROSINT","25MCG","30","Select","Select",""],["","00228202950","ALPRAZOLAM","0.5MG","30","Select","Select",""],["","69097084615","CYCLOBENZAPR","10MG","90","Select","Select",""],["","70710113908","FLUCONAZOLE","150MG","2","Select","Select",""],["","65862050320","AMOX\/K","875-125","20","Select","Select",""],["","69097015907","MELOXICAM","15MG","30","Select","Select",""],["","43598072101","HYDROXYCHLOR","200MG","28","Select","Select",""],["","42799080601","IVERMECTIN","3MG","9","Select","Select",""],["","65862001501","AMOXICILLIN","875MG","20","Select","Select",""],["","00456111030","VIIBRYD","10MG","30","Select","Select",""],["","69097012303","TOPIRAMATE","50MG","30","Select","Select",""],["","65862007701","CIPROFLOXACN","500MG","10","Select","Select",""],["","59267100002","PFIZER","COVID-19","0","Select","Select",""],["","67877032105","IBUPROFEN","800MG","30","Select","Select",""],["","69097081312","GABAPENTIN","100MG","90","Select","Select",""],["","65862053750","LEVOFLOXACIN","500MG","10","Select","Select",""],["","68180016106","AZITHROMYCIN","500MG","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":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","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":""}]}]}