{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PAULA   D MEADOWS","gend":1,"add":"PO BOX 90","city":"MAVISDALE","state":"VA","zip":"24627-9998","dob":"1976-07-01","age":"","mstatus":"","insh":"1580200*01","cliId":"","pno":"276\/498-4319","cno":"","email":"","ename":"","eno":"","pphy":"KEENE, MELISSA N MD","ppno":"276\/935-1760","pcpadd":"1532 SLATE CREEK RD","pcpcity":"GRUNDY","pcpstate":"VA","pcpzip":24614,"pcpcounty":"","pcpid":"","pcpname":"BUCHANAN HEALTH CARE LLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"SOUTHWEST","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":["M54.5","R60.0","J32.8","Z68.42","M25.561","M25.562","K04.7","M15.0","H65.191","K08.89","I10.","F17.210","J06.9","R05.","R07.9","K21.9","Z79.899","R10.2","R30.0","R35.0","R39.15","K58.1","R11.0","J30.1","L29.8","L02.91","L02.439","Z03.818","N13.1","Z13.6","Z71.6","N39.0","K91.89","N20.1","E86.0","N83.201","R10.31","E66.01","Z68.41","N13.2","G90.09","N23.","G89.18","N93.9","N73.9","N13.30","N13.5","N13.39","R31.29","R19.00","Z87.442","N80.0","N85.8","N73.6","N39.46","R35.1","R39.81","R10.9","R10.32","T83.031A","R10.12","J30.89","J45.909","F34.1","G43.009","E55.9","J20.0","K30.","Z90.710","G89.4","E66.9","Z90.49","Z72.0","Z79.891","T83.9XXA","T83.038A","Z98.890","Z79.51","Z46.6","V58.89","N10."],"date":["2021-08-09","2021-02-03","2020-06-22","2020-06-22","2021-08-09","2021-08-09","2021-10-08","2021-08-09","2021-01-11","2021-10-08","2021-10-08","2021-10-08","2021-08-27","2021-08-27","2020-02-10","2021-10-08","2021-10-08","2020-01-21","2020-01-21","2020-01-21","2020-01-21","2020-01-21","2020-01-21","2020-05-22","2020-05-22","2021-08-09","2021-08-09","2021-01-13","2020-02-13","2021-02-03","2021-02-03","2020-01-19","2019-05-05","2019-05-28","2019-06-24","2019-04-22","2019-02-06","2019-12-12","2019-02-06","2019-05-06","2019-06-24","2019-08-19","2019-08-28","2019-01-31","2019-06-25","2019-08-19","2019-08-19","2019-08-13","2019-07-15","2019-05-06","2019-07-15","2019-04-22","2019-04-22","2019-04-22","2019-08-19","2019-06-10","2019-07-29","2019-07-08","2019-07-08","2019-08-30","2019-09-17","2019-09-17","2019-06-21","2019-03-18","2019-03-18","2019-03-18","2019-06-21","2019-06-21","2019-08-28","2019-08-28","2019-08-28","2019-08-28","2019-08-28","2019-08-28","2019-08-30","2019-08-30","2019-08-30","2019-08-30","2019-07-09","2019-08-28","2019-10-06"],"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":[["","57237000201","HYDROCHLOROT","CAP 12.5MG","30","Select","Select",""],["","","CYANOCOBALAM","INJ 1000MCG","","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00406012405","HYDROCO\/APAP","TAB 7.5-325","60","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","16729011917","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","","LIDOCAINE","PAD 0.05","","Select","Select",""],["","","DOK","CAP 100MG","","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","","AMOX\/K","TAB 500-125","","Select","Select",""],["","08290309626","1ML","MIS 25GX5\/8\"","1","Select","Select",""],["","","PREDNISONE","TAB 10MG","","Select","Select",""],["","68462039610","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","53746027205","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","68462018022","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","","NEO\/POLY\/HC","SOL 1% OTIC","","Select","Select",""],["","08290305787","3ML","MIS 25GX1\"","1","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","00904699880","DOCUSATE","CAP 100MG","60","Select","Select",""],["","21922001605","CLOBETASOL","CRE 0.0005","30","Select","Select",""],["","68001043490","NICOTINE","DIS STEP 1","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","51293080101","PHENAZOPYRID","TAB 100MG","6","Select","Select",""],["","33342002108","LEVOFLOXACIN","TAB 250MG","10","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","","MULTI-USER","KIT BLOOD PR","","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","6","Select","Select",""],["","","5","MIS MONITOR","","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","","FAMOTIDINE","TAB 40MG","","Select","Select",""],["","68001025604","DULOXETINE","CAP 30MG","30","Select","Select",""],["","","CIPRO\/DEXA","SUS 0.3-0.1%","","Select","Select",""],["","","CIPRODEX","SUS 0.3-0.1%","","Select","Select",""],["","","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","","KETOROLAC","TAB 10MG","","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","10","Select","Select",""],["","69315011710","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","00378301501","NABUMETONE","TAB 500MG","30","Select","Select",""],["","57237001401","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00781214501","AMPICILLIN","CAP 500MG","20","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","100","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","30","Select","Select",""],["","00378115005","BUSPIRONE","TAB 10MG","60","Select","Select",""],["","00904572872","ALLERGY","TAB 10MG","30","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","71093011105","GABAPENTIN","TAB 600MG","60","Select","Select",""],["","55111017915","TIZANIDINE","TAB 2MG","90","Select","Select",""],["","67877021620","CEFUROXIME","TAB 500MG","28","Select","Select",""],["","57664037718","TRAMADOL","TAB 50MG","28","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","69452014330","BENZONATATE","CAP 100MG","60","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":""}]}]}