{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GARY   L PENNINGTON JR","gend":0,"add":"208 E GLADE ST APT A","city":"GLADE SPRING","state":"VA","zip":"24340-9998","dob":"1974-10-07","age":"","mstatus":"","insh":"20033280*01","cliId":"","pno":"276\/739-8622","cno":"","email":"","ename":"","eno":"","pphy":"BRALLEY, EMILY G DO","ppno":"276\/783-8123","pcpadd":"1046 TERRACE DRIVE","pcpcity":"MARION","pcpstate":"VA","pcpzip":24354,"pcpcounty":"","pcpid":"","pcpname":"ROYAL OAK MEDICAL ASSOCIATES PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"276\/783-1820","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","L03.311","L02.211","S33.5XXA","S00.01XA","S00.81XA","Y04.0XXA","J30.9","K21.9","K22.3","M54.5","G43.009","I10.","G62.9","M79.662","M79.661","F41.1","R94.5","Z68.28","R07.9","W10.9XXA","S93.401A","W20.8XXA","R10.9","G93.40","R55.","Z72.89","M25.561","Z53.29","F33.1","G89.29","M67.51","M22.41","E78.5"],"date":["2022-04-27","2021-08-21","2021-08-21","2021-06-28","2021-06-28","2021-06-28","2021-06-28","2019-05-07","2022-04-07","2019-05-07","2019-05-07","2019-05-07","2022-04-07","2019-05-07","2019-05-07","2019-05-07","2019-05-07","2019-05-07","2019-05-07","2020-11-02","2020-11-01","2019-10-22","2019-10-22","2021-04-18","2020-11-02","2020-11-02","2020-11-02","2022-04-07","2022-03-31","2022-11-03","2022-02-14","2022-04-07","2022-04-07","2022-04-07"],"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":[["","55111068405","IBU","TAB 800MG","60","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","55111073530","SIMVASTATIN","TAB 10MG","30","Select","Select",""],["","53746010905","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","00228315573","BUPREN\/NALOX","SUB 8-2MG","56","Select","Select",""],["","55111018010","TIZANIDINE","TAB 4MG","90","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","56","Select","Select",""],["","55111029209","SUMATRIPTAN","TAB 50MG","9","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","58160088552","FLUARIX","INJ 2020-21","0","Select","Select",""],["","00378207401","LISINOPRIL","TAB 10MG","60","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","00781717612","NALOXONE","SPR ","2","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","71717010350","GABAPENTIN","TAB 800MG","90","Select","Select",""],["","62175013637","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","20","Select","Select",""],["","00603533932","PREDNISONE","TAB 20MG","18","Select","Select",""],["","13668009205","PRAMIPEXOLE","TAB 0.25MG","30","Select","Select",""],["","55111012701","CIPROFLOXACN","TAB 500MG","28","Select","Select",""],["","60432027516","BROM\/PSE\/DM","SYP ","120","Select","Select",""],["","00603104458","BROMOPHED","SYP ","120","Select","Select",""],["","60432083716","BROMFED","SYP ","120","Select","Select",""],["","10956078850","REFENESEN","TAB 400MG","60","Select","Select",""],["","00185067405","HYDROXYZ","CAP 25MG","84","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","59762306001","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","50383059316","BROMETANE","SYP ","120","Select","Select",""],["","69238110005","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","59762330403","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","69097012215","TOPIRAMATE","TAB 25MG","30","Select","Select",""],["","00378140496","RIZATRIPTAN","TAB 10MG","9","Select","Select",""],["","45802008801","ALBUTEROL","AER HFA","8","Select","Select",""],["","50580072636","ZYRTEC","TAB 10MG","30","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":""}]}]}