{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRITTANY   N RODGERS","gend":1,"add":"1446 W FAYETTE ST APT 74","city":"MARTINSVILLE","state":"VA","zip":"24112-9998","dob":"1995-04-03","age":"","mstatus":"","insh":"1540496*01","cliId":"","pno":"276\/790-1795","cno":"","email":"","ename":"","eno":"","pphy":"SESSOR-KENDRICK, JONI NICOLE NP","ppno":"276\/632-2966","pcpadd":"287 COMMONWEALTH BLVD","pcpcity":"MARTINSVILLE","pcpstate":"VA","pcpzip":24112,"pcpcounty":"","pcpid":"","pcpname":"PIEDMONT ACCESS TO HEALTH SERVICES INC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"276\/632-0841","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L60.0","E03.9","J01.10","G43.109","R10.2","Z20.828","R35.0","R39.82","N83.201","R39.15","R19.7","A09.","I10.","M79.604","N76.0","B96.89","L03.031","Z87.891","R30.0","R20.0","L98.9","Z11.3","Z68.43","M54.41","Z71.89","B37.3","Z68.42","Z30.41","Z20.822","J06.9","E66.01","Z83.3","J01.00","J30.9","Z30.46","J45.30","D18.01","R20.8","L29.8","R58.","L53.8","Z01.411","Z12.4","K52.9","J30.2","J45.998","E07.89","R11.0","R10.11","H66.93","J01.90"],"date":["2021-02-17","2022-01-04","2020-02-25","2020-02-25","2020-07-20","2022-11-22","2021-03-24","2021-03-24","2021-03-24","2022-03-31","2021-05-16","2022-04-14","2022-07-16","2020-07-02","2020-10-22","2020-10-22","2020-10-20","2020-11-24","2020-07-15","2021-03-23","2021-06-29","2020-10-22","2020-10-22","2022-05-26","2020-07-27","2021-12-15","2022-07-16","2021-12-15","2022-07-16","2022-11-22","2022-07-16","2022-01-04","2020-08-05","2020-08-05","2020-10-02","2020-11-24","2021-08-18","2021-08-18","2021-08-18","2021-08-18","2021-08-18","2021-12-15","2021-12-15","2021-12-22","2022-07-16","2022-07-16","2022-07-16","2022-04-14","2022-04-14","2022-06-28","2022-06-28"],"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":[["","68462030529","NORETHINDRON","TAB 0.35MG","28","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","68382025601","OXYBUTYNIN","TAB 10MG ER","90","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","33342032815","TRIAMCINOLON","CRE 0.005","15","Select","Select",""],["","64380071207","BENZONATATE","CAP 100MG","30","Select","Select",""],["","00378180310","LEVOTHYROXIN","TAB 50MCG","30","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","68382002210","ATENOLOL","TAB 25MG","90","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","30","Select","Select",""],["","65862050220","AMOX\/K","TAB 500-125","20","Select","Select",""],["","60432027516","BROM\/PSE\/DM","SYP ","300","Select","Select",""],["","42571012290","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","58160084252","BOOSTRIX","INJ ","0","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","7","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","00555902658","JUNEL","TAB 43831","28","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","31722070530","VALACYCLOVIR","TAB 1GM","20","Select","Select",""],["","68682045570","METRONIDAZOL","GEL 0.75%VAG","70","Select","Select",""],["","65862094088","AUROVELA","TAB 43831","28","Select","Select",""],["","00168034646","TERCONAZOLE","CRE 0.004","45","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","00713072615","MOMETASONE","CRE 0.001","15","Select","Select",""],["","00430042014","LO","TAB 40452","28","Select","Select",""],["","68462029817","CLOTRIM\/BETA","CRE DIPROP","15","Select","Select",""],["","50458009801","ELMIRON","CAP 100MG","90","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":""}]}]}