{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"FAYETTE   L THORNTON","gend":1,"add":"2715 MARTINGALE RD APT C","city":"COLONIAL HEIGHTS","state":"VA","zip":"23834-9998","dob":"1969-08-21","age":"","mstatus":"","insh":"1007290*01","cliId":"","pno":"804\/744-3948","cno":"804\/526-4380","email":"","ename":"","eno":"","pphy":"TUNSTALL, JUNE R MD","ppno":"804\/458-6396","pcpadd":"406 NORTH 6TH STREET","pcpcity":"HOPEWELL","pcpstate":"VA","pcpzip":23860,"pcpcounty":"","pcpid":"","pcpname":"June R. Tunstall, MD, PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/458-4934","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","F55.8","R06.02","J18.9","R94.31","Z01.419","Z23.","N94.10","N95.2","M32.9","R51.9","S93.401A","W01.198A","Z76.0","Z20.828","J40.","R09.81","R05.9","B34.9","Z20.822","R05.","R50.9","M17.11","R49.0","E78.5","J44.9","Z79.02","Z79.51","Z79.890","Z86.73","J44.1","Z86.2","I70.90","E78.00","E03.9","D68.59","L93.0","R09.89","I10.","F32.9","F41.9","M31.6","M35.3","M17.12","G89.29","M25.50","R22.0","K02.9","J84.89","J45.20","I63.9","Z12.31","Z68.24","M35.9","J84.9","K08.89","K13.79","Z79.899","H52.03","H52.4","M25.569","R06.00","M17.0","R09.82","M35.1","K22.4","D53.0","J42.","R30.9"],"date":["2021-11-23","2020-11-01","2021-07-22","2020-05-18","2020-04-20","2020-11-17","2020-11-17","2020-11-17","2020-11-17","2021-12-02","2021-10-11","2021-06-24","2021-06-24","2021-07-22","2020-12-21","2021-09-30","2020-12-21","2021-10-11","2021-10-11","2021-10-11","2021-07-22","2020-05-18","2021-03-05","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2021-09-09","2021-08-16","2021-08-16","2021-08-16","2021-08-21","2021-08-16","2021-09-09","2020-12-21","2021-07-22","2021-05-05","2020-12-21","2021-05-18","2021-05-18","2021-05-18","2021-07-22","2021-09-30","2021-08-21","2021-08-21","2020-06-24","2020-06-24","2020-06-24","2020-06-24","2020-06-24","2020-09-17","2020-10-27","2021-08-21","2021-05-05","2021-10-14","2021-10-14","2021-10-14","2020-09-24","2021-08-24","2021-08-24","2020-06-18","2020-10-27","2020-10-27","2020-10-27","2020-12-01","2020-12-01"],"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":{"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":[["","00054016629","MYCOPHENOLAT","TAB 500MG","120","Select","Select",""],["","69238154401","HYDROXYCHLOR","TAB 200MG","60","Select","Select",""],["","29300014901","QUETIAPINE","TAB 100MG","30","Select","Select",""],["","65162003310","APAP\/CODEINE","TAB 300-30MG","4","Select","Select",""],["","10702002301","OXYCODONE","CAP 5MG","5","Select","Select",""],["","59746017206","PREDNISONE","TAB 5MG","30","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","14","Select","Select",""],["","50383077504","LIDOCAINE","SOL 2% VISC","100","Select","Select",""],["","65162063609","PANTOPRAZOLE","TAB 20MG","60","Select","Select",""],["","55111019690","CLOPIDOGREL","TAB 75MG","30","Select","Select",""],["","62332025118","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","57664037708","TRAMADOL","TAB 50MG","14","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","70436015542","PROMETHAZINE","SOL DM","120","Select","Select",""],["","68180097001","LEVOTHYROXIN","TAB 112MCG","90","Select","Select",""],["","00456074613","AERCHMBR","MIS LRG MASK","1","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","64380078706","BUSPIRONE","TAB 7.5MG","60","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","60505017009","PRAVASTATIN","TAB 40MG","30","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","21","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","90","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","64380071206","BENZONATATE","CAP 100MG","120","Select","Select",""],["","68382005101","MELOXICAM","TAB 15MG","30","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","42571025101","CLINDAMYCIN","CAP 150MG","63","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":""}]}]}