{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ELLEN  M BAIRD","gend":1,"add":"1705 DERBY ROAD","city":"APPALACHIA","state":"VA","zip":24216,"dob":"1971-10-22","age":"","mstatus":"","insh":"1574998*01","cliId":"","pno":"276\/219-1375","cno":"","email":"","ename":"","eno":"","pphy":"MAYS, WHITNEY B","ppno":"276\/679-0800","pcpadd":"338 COEBURN AVE SW","pcpcity":"NORTON","pcpstate":"VA","pcpzip":24216,"pcpcounty":"","pcpid":"","pcpname":"NORTON COMMUNITY PHYSICIAN SERVICES LLC","plan":"OHP","program":"Medicaid","lob":"M4","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"276\/395-8297","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K52.9","R68.89","R11.2","R19.7","E11.40","Z79.4","M54.2","M48.02","M47.812","I10.","M25.561","M25.361","M25.551","G89.29","Z03.818","E11.65","R35.0","N39.0","R11.0","R73.9","A49.9","J18.9","Z87.891","F41.9","Z63.4","F32.9","M70.61","M70.62","M25.60","R53.1","R26.2","M47.816","M17.0","Z79.899","G62.9","E11.9","H65.91","NO DATA","N83.8","L23.7","M54.5","E03.9","R42.","R52.","R05.","J40."],"date":["2020-01-03","2020-01-03","2020-07-19","2020-01-03","2021-06-08","2021-07-20","2020-07-24","2020-07-24","2020-07-24","2021-06-08","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-04-10","2021-06-08","2021-06-08","2021-06-08","2021-06-08","2021-06-08","2021-06-08","2021-12-19","2021-12-19","2020-02-17","2020-02-17","2020-02-17","2020-09-02","2020-09-02","2020-09-02","2020-09-02","2020-09-02","2021-01-07","2020-01-02","2021-07-20","2021-07-20","2021-07-20","2021-07-20","2020-08-07","2021-03-23","2020-05-21","2021-01-07","2021-01-07","2020-07-19","2020-10-16","2020-10-16","2020-01-09"],"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":[["","16571066001","MECLIZINE","TAB 12.5MG","90","Select","Select",""],["","08290328418","INSULIN","MIS 1ML\/31G","100","Select","Select",""],["","43386035701","HYDROCO\/APAP","TAB 7.5-325","30","Select","Select",""],["","65862052305","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","00169750111","NOVOLOG","INJ 100\/ML","10","Select","Select",""],["","00169643810","LEVEMIR","INJ FLEXTOUC","15","Select","Select",""],["","68180016006","AZITHROMYCIN","TAB 250MG","5","Select","Select",""],["","71093014005","METHOCARBAM","TAB 500MG","60","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","08290320119","BD  PEN NEEDL","MIS 31GX5MM","100","Select","Select",""],["","31722070290","LOSARTAN","TAB 100MG","90","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","15","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","65162068090","PROMETHAZINE","SOL DM","118","Select","Select",""],["","19515081852","FLULAVAL","INJ 2021-22","0","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","67877054360","CEFDINIR","CAP 300MG","14","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","35","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}