{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SANDRA   B MARSHALL","gend":1,"add":"5881 CARTERSVILLE ROAD","city":"POWHATAN","state":"VA","zip":"23139-9998","dob":"1960-04-12","age":"","mstatus":"","insh":"20031543*01","cliId":"","pno":"804\/709-7567","cno":"","email":"","ename":"","eno":"","pphy":"JOSEPH, SHARON MD","ppno":"804\/285-6050","pcpadd":"STE D 3452 ANDERSON HWY","pcpcity":"POWHATAN","pcpstate":"VA","pcpzip":23139,"pcpcounty":"","pcpid":"","pcpname":"POWHATAN MEDICAL ASSOCIATES","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/598-2481","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K86.89","B37.3","NO DATA","D36.7","Z68.34","E11.21","E55.9","I10.","E78.2","Z76.0","M43.16","Z87.891","K86.1","J45.20","E11.42","E11.9","Z12.11","Z13.220","Z79.4","Z68.33","R11.0","R10.32","L72.0","Z68.36","R13.10","J06.9","N89.8","M54.9","L20.9","M54.42","B35.1","M79.89","M54.41","G89.29","M54.16","R06.02","Z68.35","R30.0","L84.","E11.40","M79.604","Z91.09","G43.809","R21.","M79.605","K86.81","M77.12","B34.9","J45.21","R05.1","R80.9","E11.22","I12.9","Z79.84"],"date":["2021-04-14","2021-04-14","2022-10-18","2020-11-19","2020-11-19","2022-08-29","2022-10-18","2022-08-29","2022-10-18","2021-05-20","2021-09-09","2020-03-17","2021-09-13","2020-10-05","2020-10-05","2021-11-15","2021-11-23","2020-10-05","2022-10-18","2020-10-05","2020-04-10","2020-04-10","2020-12-18","2021-05-20","2021-11-23","2020-01-23","2020-07-22","2020-07-22","2020-07-22","2021-05-20","2021-06-22","2021-05-20","2021-05-20","2021-05-20","2021-09-09","2021-11-15","2021-11-15","2021-04-02","2021-06-22","2021-06-22","2019-11-21","2019-11-21","2019-04-29","2019-04-29","2019-11-21","2019-07-15","2019-02-13","2019-12-16","2019-12-16","2022-01-25","2022-08-29","2022-10-18","2022-10-18","2022-10-18"],"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":[["","","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","9","Select","Select",""],["","08290320122","BD  PEN NEEDL","MIS 32GX4MM","100","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","","FLUZONE","INJ 2020-21","","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","00955172805","INSULIN","INJ 100U\/ML","15","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","","MOMETASONE","OIN 0.001","","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","30","Select","Select",""],["","","BENZONATATE","CAP 100MG","","Select","Select",""],["","65162017910","METFORMIN","TAB 750MG ER","60","Select","Select",""],["","00032301613","CREON","CAP 36000UNT","360","Select","Select",""],["","31722070290","LOSARTAN","TAB 100MG","30","Select","Select",""],["","53885024450","ONETOUCH","TES ULTRA","100","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","60","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","00310621030","FARXIGA","TAB 10MG","90","Select","Select",""],["","00254100752","ALBUTEROL","AER HFA","7","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","80777028299","MODERNA","INJ BA4\/BA5","0","Select","Select",""],["","00169369619","NOVOLOG","INJ FLEXPEN","15","Select","Select",""],["","00591565810","CYCLOBENZAPR","TAB 10MG","12","Select","Select",""],["","59779045888","ALLERGY","TAB 10MG","90","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","00169406012","VICTOZA","INJ 18MG\/3ML","18","Select","Select",""],["","00168000615","TRIAMCINOLON","OIN 0.001","30","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","30","Select","Select",""],["","52268020101","SUTAB","TAB ","24","Select","Select",""],["","00832105410","BACLOFEN","TAB 10MG","15","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","30","Select","Select",""],["","43386006019","GAVILYTE-C","SOL ","4000","Select","Select",""],["","00121086802","NYSTATIN","SUS 100000","200","Select","Select",""],["","90166001334","LANCETS","MIS 33G","100","Select","Select",""],["","55111032101","GLIMEPIRIDE","TAB 2MG","30","Select","Select",""],["","00093770198","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","55111029336","SUMATRIPTAN","TAB 100MG","9","Select","Select",""],["","00085113201","PROVENTIL","AER HFA","7","Select","Select",""],["","59779076678","PAIN","TAB 325MG","30","Select","Select",""],["","","DOXYCYC","TAB 100MG","","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","","SHINGRIX","INJ 50\/0.5ML","","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","20","Select","Select",""],["","70461031903","FLUCLVX","INJ 2019-20","0","Select","Select",""],["","58657050016","CODEINE\/GG","SOL 10-100\/5","120","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","37000014343","ALIGN","CAP 4MG","30","Select","Select",""],["","00591544310","PREDNISONE","TAB 20MG","8","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":{"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":""}]}]}