{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CRYSTAL   D ORFIELD","gend":1,"add":"135 WOODSTONE LN APT 301","city":"BRISTOL","state":"VA","zip":"24201-9998","dob":"1985-07-03","age":"","mstatus":"","insh":"20032928*01","cliId":"","pno":"276\/591-9920","cno":"","email":"","ename":"","eno":"","pphy":"HOPKINS, ANDREA L MD","ppno":"423\/989-4050","pcpadd":"208 MEDICAL PARK BLVD","pcpcity":"BRISTOL","pcpstate":"TN","pcpzip":37620,"pcpcounty":"","pcpid":"","pcpname":"MEDICAL EDUCATION ASSISTANCE CORPORATION","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"423\/990-3044","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N17.9","E83.39","Z20.822","F11.20","F41.9","R64.","Z51.81","Z79.899","J44.9","N94.6","T50.901A","G93.41","M62.82","E87.0","E87.2","Z68.1","R63.6","NO DATA","F11.10","F43.10","F12.90","F17.210","F19.90","D72.829","I49.8","I49.3","I45.10","I45.81","R41.82","R45.6","R09.02","V23.9","O47.03","Z3A.32","Z76.2","Z71.89","O34.211","O99.324","O36.5930","Z3A.40","O41.00X0","O99.52","F13.90","Z79.51","Z79.52","Z37.0","O99.334","Z30.2","O48.0","O41.03X0","O99.322","Z23."],"date":["2021-11-06","2021-11-03","2021-11-03","2021-12-08","2021-11-15","2021-11-15","2021-12-08","2021-12-08","2021-12-08","2021-12-08","2021-11-03","2021-11-06","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-06","2021-11-06","2021-11-10","2021-11-10","2021-11-10","2021-11-10","2021-11-03","2021-11-03","2021-11-03","2019-08-01","2019-04-25","2019-04-25","2019-03-01","2019-05-31","2019-06-20","2019-06-20","2019-06-20","2019-06-20","2019-06-20","2019-06-20","2019-06-20","2019-06-20","2019-06-20","2019-06-20","2019-06-20","2019-06-20","2019-06-20","2019-06-20","2019-01-09","2019-04-08"],"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":[["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","00085113204","PROVENTIL","AER HFA","7","Select","Select",""],["","00173069500","ADVAIR","AER 100\/50","60","Select","Select",""],["","00378932032","WIXELA","AER 100\/50","60","Select","Select",""],["","00093083205","CLONAZEPAM","TAB 0.5MG","7","Select","Select",""],["","27241009803","DULOXETINE","CAP 30MG","30","Select","Select",""],["","00406802003","BUPREN\/NALOX","SUB 8-2MG","14","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00054032656","FLUTIC\/SALME","AER 100\/50","60","Select","Select",""],["","62756045983","BUPRENORPHIN","SUB 2MG","7","Select","Select",""],["","00093506105","HYDROXYZ","TAB 25MG","60","Select","Select",""],["","57896040110","DOCUSATE","CAP 100MG","60","Select","Select",""],["","57237014935","FLUCONAZOLE","SUS 10MG\/ML","35","Select","Select",""],["","47781019605","OXYCOD\/APAP","TAB 5-325MG","15","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","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":""}]}]}