{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAMEKA   R PURYEAR","gend":1,"add":"401 JEFFERSON ST APT 2","city":"CHASE CITY","state":"VA","zip":"23924-9998","dob":"1988-09-05","age":"","mstatus":"","insh":"20032902*01","cliId":"","pno":"434\/374-2036","cno":"","email":"","ename":"","eno":"","pphy":"GOODWIN, MARIE I NP","ppno":"434\/738-6420","pcpadd":"380 WASHINGTON STREET","pcpcity":"BOYDTON","pcpstate":"VA","pcpzip":23917,"pcpcounty":"","pcpid":"","pcpname":"PIEDMONT ACCESS TO HEALTH SERVICES INC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/738-6054","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.81","R10.9","R11.2","J45.21","F31.31","E66.9","F25.0","K57.32","R10.30","R19.7","Z20.822","K59.01","R11.0","R63.4","Z80.0","Z83.71","K21.9","K29.60","B96.81","R51.9","G43.909","M54.16","I10.","F31.9","F17.210","E66.09","E55.9","R53.83","Z68.31","R93.5","R10.12","R19.00","Z71.2","R51.","R20.0","Z79.899","R87.612","R10.2","I11.9","R53.1","G44.221","R07.89","R42.","E78.2","M54.5","K80.20","M47.9","N87.1","K81.9","R10.13","Z91.018","M54.17","K59.04","R14.0","R10.84","Z98.890","K80.80","R07.9","R06.02","D06.0"],"date":["2020-01-31","2021-07-26","2021-07-26","2021-08-19","2021-08-19","2021-08-19","2020-02-18","2021-05-03","2021-05-05","2021-05-03","2021-05-24","2021-07-26","2021-07-13","2021-06-10","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-13","2020-03-03","2020-03-03","2020-03-06","2020-03-03","2020-03-03","2020-03-06","2020-03-06","2020-03-06","2020-03-06","2021-05-18","2021-05-05","2021-05-05","2020-04-16","2020-04-16","2020-04-16","2020-04-16","2019-01-17","2019-01-17","2019-09-05","2019-11-13","2019-01-07","2019-08-27","2019-08-27","2019-08-27","2019-11-19","2019-02-08","2019-10-21","2019-01-25","2019-01-28","2019-09-05","2019-11-15","2019-11-21","2019-11-21","2019-11-21","2019-11-21","2019-01-28","2019-01-29","2019-08-20","2019-08-20","2019-01-25"],"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":[["","65862007701","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","30","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","30","Select","Select",""],["","71930005552","APAP\/CODEINE","TAB 300-30MG","16","Select","Select",""],["","10572030201","PEG-3350\/KCL","SOL \/SODIUM","4000","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","65862053750","LEVOFLOXACIN","TAB 500MG","14","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","10","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","28","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","56","Select","Select",""],["","45802075930","PROMETHAZINE","SUP 25MG","20","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","43547030303","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","","ZOLPIDEM","TAB 5MG","","Select","Select",""],["","","LITHIUM","CAP 150MG","","Select","Select",""],["","23155019201","BUPROPION","TAB 100MG","4","Select","Select",""],["","","TOPIRAMATE","TAB 100MG","","Select","Select",""],["","","VITAMIN","CAP 50000UNT","","Select","Select",""],["","","LOSARTAN","TAB 25MG","","Select","Select",""],["","","SUMATRIPTAN","TAB 50MG","","Select","Select",""],["","45802046564","KETOCONAZOLE","SHA 0.02","120","Select","Select",""],["","","PREDNISONE","TAB 20MG","","Select","Select",""],["","","CLINDAMYCIN","LOT 10MG\/ML","","Select","Select",""],["","","QUETIAPINE","TAB 50MG","","Select","Select",""],["","50111043401","TRAZODONE","TAB 100MG","60","Select","Select",""],["","","HYDROXYZ","TAB 50MG","","Select","Select",""],["","","MIRTAZAPINE","TAB 15MG","","Select","Select",""],["","","DULOXETINE","CAP 30MG","","Select","Select",""],["","","OLMESA","TAB 20MG","","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","00143178701","BUT\/APAP\/CAF","TAB ","30","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","60","Select","Select",""],["","13107015590","PAROXETINE","TAB 20MG","30","Select","Select",""],["","65162047505","NORETHIN","TAB 5MG","30","Select","Select",""],["","00093738001","VENLAFAXINE","TAB 37.5MG","60","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00456120230","LINZESS","CAP 290MCG","30","Select","Select",""],["","17772010130","TROKENDI","CAP 25MG","60","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","60","Select","Select",""],["","51672135608","FLUOCIN","OIL 0.01%BDY","118","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","66689003850","LACTULOSE","SOL 20GM\/30","1800","Select","Select",""],["","43547040011","CYCLOBENZAPR","TAB 10MG","20","Select","Select",""],["","69097085207","NAPROXEN","TAB 500MG","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":""}]}]}