{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JANELL   A MYRICK","gend":1,"add":"11725 OLD STAGE ROAD","city":"PETERSBURG","state":"VA","zip":"23805-9998","dob":"1981-02-03","age":"","mstatus":"","insh":"1732649*01","cliId":"","pno":"804\/295-4563","cno":"","email":"","ename":"","eno":"","pphy":"MATHERLEE, MICHAEL D MD","ppno":"434\/246-6100","pcpadd":"12454 HARTLEY ST","pcpcity":"STONY CREEK","pcpstate":"VA","pcpzip":23882,"pcpcounty":"","pcpid":"","pcpname":"STONY CREEK COMMUNITY HEALTH CENTER","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/246-6614","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J45.909","Z91.09","Z20.822","I11.9","I50.9","K21.9","F33.0","E78.00","J45.20","K02.9","A59.01","N76.0","I10.","Z01.419","Z11.3","Z12.72","Z86.16","Z90.711","Z68.41","R05.","M19.90","K04.7","E78.5","K08.89","Z20.828","R51.9","F41.9","E66.09","Z79.899","M25.562","I11.0","R19.7","E66.9","I42.9","U07.1","R31.29","Z23.","H66.92","J02.9","R07.9","R06.02","R68.89","M79.609","I87.8","N39.0","J01.90","R10.9","G47.33","R60.9","N83.209","R11.0","K59.00","Z80.0","Z83.71","K29.70","K20.9","G44.209","R09.81","R10.13","I42.8","R42."],"date":["2021-04-05","2021-11-05","2021-09-04","2021-06-09","2021-09-28","2020-12-03","2021-06-09","2021-12-14","2021-11-05","2021-09-28","2021-05-25","2021-05-25","2021-12-14","2021-01-29","2021-01-29","2021-01-29","2021-02-24","2021-01-29","2021-12-14","2021-02-24","2021-09-28","2021-04-05","2021-05-09","2021-05-09","2021-02-11","2021-02-11","2021-06-09","2021-06-09","2021-12-14","2021-08-11","2021-09-28","2021-12-14","2021-12-14","2021-12-14","2021-01-11","2021-07-29","2021-09-28","2020-01-08","2020-01-08","2019-04-02","2019-04-02","2019-04-02","2019-05-06","2019-05-06","2019-05-13","2019-04-05","2019-04-05","2019-07-02","2019-04-16","2019-03-19","2019-05-15","2019-07-02","2019-04-16","2019-04-16","2019-07-02","2019-07-02","2019-02-18","2019-02-18","2019-05-15","2019-04-09","2019-05-19"],"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":[["","69238110005","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","55111012390","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","5","Select","Select",""],["","","AMOXICILLIN","TAB 875MG","","Select","Select",""],["","64380071306","BENZONATATE","CAP 200MG","21","Select","Select",""],["","68462035701","POT  CHLORIDE","CAP 10MEQ ER","30","Select","Select",""],["","","ALPRAZOLAM","TAB 0.25MG","","Select","Select",""],["","31722072630","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","13668011710","LOSARTAN\/HCT","TAB 100-12.5","30","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","30","Select","Select",""],["","11917004918","ACETAMIN","TAB 500MG","12","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","28","Select","Select",""],["","69230030001","ALLERGY","TAB 180MG","30","Select","Select",""],["","69097084805","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","69238110305","IBUPROFEN","TAB 800MG","15","Select","Select",""],["","00406123601","DIPHEN\/ATROP","TAB 2.5\/.025","20","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","6","Select","Select",""],["","00472037915","CLOTRIM\/BETA","CRE DIPROP","15","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","20","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00527130801","PHENTERMINE","CAP 30MG","30","Select","Select",""],["","00085113204","PROVENTIL","AER HFA","7","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","","FEXOFENADINE","TAB 60MG","","Select","Select",""],["","","LIDOCAINE","SOL 2% VISC","","Select","Select",""],["","","FLUCLVX","INJ 2020-21","","Select","Select",""],["","65862014405","CARVEDILOL","TAB 12.5MG","60","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00527169505","BUT\/APAP\/CAF","TAB ","10","Select","Select",""],["","59762040101","SUCRALFATE","TAB 1GM","30","Select","Select",""],["","68382050010","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","67618010160","COLACE","CAP 100MG","60","Select","Select",""],["","45802086866","POLYETH","POW 3350 NF","30","Select","Select",""],["","47781047013","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","00555902658","JUNEL","TAB 44581","28","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","00004080085","TAMIFLU","CAP 75MG","10","Select","Select",""],["","11523726803","MIRALAX","POW 3350 NF","30","Select","Select",""],["","00904645760","DOK","CAP 100MG","60","Select","Select",""],["","55111012701","CIPROFLOXACN","TAB 500MG","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":[]}},{"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":""}]}]}