{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ELIZABETH   C RASMUSSEN","gend":1,"add":"4450 JOHNSON MOUNTAIN ROAD","city":"HUDDLESTON","state":"VA","zip":"24104-9998","dob":"1964-04-29","age":"","mstatus":"","insh":"20033771*01","cliId":"","pno":"804\/577-3006","cno":"","email":"","ename":"","eno":"","pphy":"HAYEK, CRAIG MD","ppno":"540\/425-7910","pcpadd":"582 BLUE RIDGE AVE","pcpcity":"BEDFORD","pcpstate":"VA","pcpzip":24523,"pcpcounty":"","pcpid":"","pcpname":"JOHNSON HEALTH CENTER","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/583-5149","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.16","M47.816","NO DATA","M16.11","M51.36","D50.9","D51.9","Z47.1","Z96.641","M79.7","J44.9","D64.9","F31.9","R10.9","Z91.81","Z79.891","Z79.82","Z79.51","L98.1","L28.1","R21.","E53.8","F43.10","R13.10","M54.5","M25.551","M43.16","Z01.818","M54.31","D47.3","K21.9","E55.9","K62.5","R00.0","R03.0","L53.9","T18.9XXA","Z98.84","R11.2","K22.8","K64.9","R22.2","S00.93XA","S40.011A","M54.2","T18.2XXA","S20.469A","S40.862A","S40.861A","S70.361A","S70.362A"],"date":["2020-10-05","2020-10-05","2021-01-19","2021-05-18","2021-06-01","2021-07-21","2021-04-08","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2020-02-27","2020-02-27","2020-02-27","2020-08-14","2020-08-14","2020-01-31","2020-12-01","2021-01-27","2020-12-01","2021-05-07","2020-08-17","2020-07-16","2020-07-16","2020-07-16","2019-05-06","2019-10-12","2019-10-12","2019-10-12","2019-06-04","2019-06-14","2019-06-14","2019-05-06","2019-05-06","2019-02-07","2019-04-05","2019-04-05","2019-04-05","2019-06-14","2019-10-18","2019-10-18","2019-10-18","2019-10-18","2019-10-18"],"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":[["","59310057922","PROAIR","AER ","8","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","68180044801","QUETIAPINE","TAB 200MG","30","Select","Select",""],["","50228017705","GABAPENTIN","TAB 600MG","120","Select","Select",""],["","00093406801","PRAZOSIN","CAP 2MG","30","Select","Select",""],["","69918030130","TRANEX","TAB 650MG","3","Select","Select",""],["","","HYDROCO\/APAP","TAB 7.5-325","","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00597002402","COMBIVENT","AER 20-100","4","Select","Select",""],["","","OMEPRAZOLE","CAP 20MG DR","","Select","Select",""],["","","FLUOXETINE","TAB 10MG","","Select","Select",""],["","65862008501","CEFADROXIL","CAP 500MG","14","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","","SUCRALFATE","TAB 1GM","","Select","Select",""],["","","TRIAMCINOLON","OIN 0.001","","Select","Select",""],["","69336012410","FENOPROFEN","CAP 200MG","100","Select","Select",""],["","","PEG3350","POW ","","Select","Select",""],["","","VITAMIN","TAB 5000UNIT","","Select","Select",""],["","","EQ","CAP SOFTENER","","Select","Select",""],["","65862069730","VENLAFAXINE","CAP 150MG ER","30","Select","Select",""],["","","VENTOLIN","AER ","","Select","Select",""],["","71800063115","LIDOCAINE","CRE TETRACAI","120","Select","Select",""],["","","MUPIROCIN","OIN 0.02","","Select","Select",""],["","","METHOCARBAM","TAB 750MG","","Select","Select",""],["","","IRON","TAB 325MG","","Select","Select",""],["","","INCRUSE","INH 62.5MCG","","Select","Select",""],["","","SPIRIVA","CAP HANDIHLR","","Select","Select",""],["","13107003134","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","Select","Select",""],["","10702000709","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","28","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00603533715","PREDNISONE","PAK 5MG","21","Select","Select",""],["","45802015194","FLUOCINONIDE","CRE 0.001","120","Select","Select",""],["","57237004101","PENICILLN","TAB 500MG","28","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","16","Select","Select",""],["","10572010001","PEG-3350","SOL ELECTROL","4000","Select","Select",""],["","68180095604","CLOBETASOL","CRE 0.0005","60","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","00781711783","CALCIPOTRIEN","CRE 0.00005","120","Select","Select",""],["","40085071645","DOXEPIN","CRE 0.05","45","Select","Select",""],["","60505317007","OMEGA-3-ACID","CAP 1GM","360","Select","Select",""],["","49281071910","FLUBLOK","INJ 2019-20","0","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":""}]}]}