{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HOLLEY   A KING","gend":1,"add":"2377 COTTON PATCH ROAD TAMMY KING","city":"GRETNA","state":"VA","zip":"24557-9998","dob":"1991-10-20","age":"","mstatus":"","insh":"20030651*01","cliId":"","pno":"434\/709-4096","cno":"","email":"","ename":"","eno":"","pphy":"GATEWOOD, TINA PA","ppno":"434\/791-4122","pcpadd":"705 MAIN ST","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"PIEDMONT ACCESS TO HEALTH SERVICES INC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"5409603763, 4344833556","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/791-4126","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R13.10","B37.3","R05.9","R30.0","Z20.828","R68.89","K02.7","K04.7","L73.9","F17.210","N39.0","R31.9","J06.9","K22.2","K44.9","NO DATA","R05.","J98.8","N92.6","K21.9","Z88.8","Z79.84","F41.9","E28.2","D35.00","G89.18","K08.9","R22.9","U07.1","Z71.9","G43.009","G40.209","F90.0","F32.9","F41.8","R53.1","R07.9","R11.10","H40.013","H25.12","H52.203","N91.2","H10.10","M79.671","R07.89","Z88.5","Z79.899","O99.513","O24.415","O99.333","Z3A.29","J96.10","O36.8120","R56.9","Z3A.20","O32.1XX0","Z3A.37","Z36.89","O69.81X0","O24.425","Z3A.39","Z37.0","Z98.890","Z88.6","Z88.0","O26.891","R50.9","E86.0","W19.XXXA","O26.893","J45.909","B34.9","J96.01","J18.9","Z72.0","O24.435","O99.335","Z39.0","Z33.1","Z3A.28","O24.419","O99.512","O32.1XX1","O99.334","O69.81X1","Z3A.38","Z3A.17","O99.519","O99.330","J40.","R09.02","J20.9","Z3A.30","Z09.","L23.9","Z20.2","Z3A.33","Z3A.35","Z30.9","R10.33","O90.0"],"date":["2021-10-05","2021-10-25","2021-10-25","2021-10-25","2021-11-04","2021-11-04","2020-04-18","2020-04-18","2020-04-18","2021-09-17","2021-09-30","2020-08-13","2021-11-06","2021-10-05","2021-10-05","2021-10-27","2020-07-09","2020-07-09","2020-11-03","2021-10-04","2021-09-16","2021-09-16","2021-10-05","2021-12-07","2021-12-07","2020-04-23","2020-04-23","2020-04-23","2021-11-06","2021-10-04","2020-02-18","2020-02-18","2020-02-18","2020-02-18","2021-02-03","2021-09-16","2021-10-27","2021-10-27","2020-09-09","2020-09-09","2020-09-09","2020-11-04","2021-04-13","2021-04-13","2021-07-31","2021-09-17","2021-07-31","2019-07-08","2019-09-03","2019-07-08","2019-07-08","2019-07-08","2019-04-27","2019-04-27","2019-04-27","2019-09-10","2019-09-03","2019-09-06","2019-09-10","2019-09-10","2019-09-10","2019-09-12","2019-10-03","2019-10-03","2019-10-03","2019-03-23","2019-03-23","2019-04-30","2019-04-30","2019-07-04","2019-07-04","2019-06-28","2019-07-08","2019-07-10","2019-07-08","2019-09-12","2019-09-12","2019-09-12","2019-06-04","2019-07-04","2019-07-12","2019-07-04","2019-09-10","2019-09-10","2019-09-10","2019-09-10","2019-04-10","2019-07-04","2019-07-04","2019-07-04","2019-07-04","2019-07-04","2019-07-12","2019-07-10","2019-07-10","2019-07-10","2019-07-29","2019-08-14","2019-12-09","2019-03-13","2019-10-03"],"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":[["","43547028110","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","20","Select","Select",""],["","","AZELASTINE","SPR 0.001","","Select","Select",""],["","17478071710","KETOTIF","DRO 0.025%OP","5","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","6","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","20","Select","Select",""],["","70954006110","PREDNISONE","TAB 50MG","5","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","","BENZONATATE","CAP 100MG","","Select","Select",""],["","00093532862","JUNEL","TAB 44581","28","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00555901658","SPRINTEC","TAB 28 DAY","28","Select","Select",""],["","11534015701","PHENTERMINE","CAP 15MG","30","Select","Select",""],["","55111064505","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","55111068305","IBU","TAB 600MG","30","Select","Select",""],["","67405060301","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00378730153","NORETH\/ETHIN","TAB FE 1\/20","84","Select","Select",""],["","59762453802","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","64764054411","PREVACID","TAB 30MG STB","30","Select","Select",""],["","64380078706","BUSPIRONE","TAB 7.5MG","60","Select","Select",""],["","","NAPROXEN","TAB 375MG","","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","240","Select","Select",""],["","","PERMETHRIN","LOT 0.01","","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","","CLINDAMYCIN","CAP 300MG","","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","14","Select","Select",""],["","","TRAMADOL","TAB 50MG","","Select","Select",""],["","63824005632","MUCINEX","TAB 30-600ER","20","Select","Select",""],["","","LICE","LIQ 0.01","","Select","Select",""],["","45802011222","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","","SMZ-TMP","TAB 800-160","","Select","Select",""],["","68180016113","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","70710101002","OSELTAMIVIR","CAP 75MG","7","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","150","Select","Select",""],["","64380080308","RANITIDINE","TAB 150MG","30","Select","Select",""],["","74300000070","DESITIN","PST 0.4","57","Select","Select",""],["","41167005820","ASPERCREME","CRE LIDOCAIN","76","Select","Select",""],["","00536118485","EXTRA","SYP 10-100\/5","240","Select","Select",""],["","67877056310","METFORMIN","TAB 1000MG","60","Select","Select",""],["","00004080085","TAMIFLU","CAP 75MG","7","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00173087410","ARNUITY","INH 100MCG","30","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","8","Select","Select",""],["","00143993905","AMOXICILLIN","CAP 500MG","6","Select","Select",""],["","69543025810","PREPLUS","TAB 27-1MG","30","Select","Select",""],["","57896040110","DOCUSATE","CAP 100MG","20","Select","Select",""],["","10702002301","OXYCODONE","CAP 5MG","10","Select","Select",""],["","53746027205","SMZ\/TMP","TAB 800-160","14","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":""}]}]}