{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHARON HUFFMAN","gend":1,"add":"4463 N LAKESIDE APT 9","city":"LEBANON","state":"VA","zip":"24266-9998","dob":"1962-02-20","age":"","mstatus":"","insh":"20038772*01","cliId":"","pno":"276\/202-8951","cno":"","email":"","ename":"","eno":"","pphy":"KEEL, TRENTON W DO","ppno":"276\/762-2300","pcpadd":"16431 WISE ST","pcpcity":"SAINT PAUL","pcpstate":"VA","pcpzip":24283,"pcpcounty":"","pcpid":"","pcpname":"MOUNTAIN STATES HEALTH ALLIANCE","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"276\/762-0612","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.3","F43.10","F32.9","J02.9","V54.16","Z96.651","S80.11XA","I10.","I48.91","S70.01XA","R26.89","R42.","H50.34","H52.4","F43.12","Z98.84","E66.01","Z68.43","J44.9","NO DATA","E78.2","G47.33","M17.11","G89.18","R10.9","K59.00","S90.30XA","M79.671","M25.571","E87.6","R07.9","J30.9","G89.29","Z78.9","Z96.659","Z47.1","M25.561","M25.661","I65.23","M70.62","M25.552","M54.5","M25.471","T14.8XXA","R07.89","K21.9","S90.01XA","W18.30XA","Z23.","G47.34","F51.01","F41.1","G25.81","N95.0","Z12.4","Z87.42","M53.3","Z01.810","R10.32","E78.5","G89.4","E53.8","E55.9","J01.40","Z20.822","M10.9","G47.30","Z79.01","Z88.0","Z12.11","Z80.0","K64.8","Z68.42","Z02.89","M51.36","F41.9","Z91.09","F33.2","I71.4","R30.0","Z01.818","Z03.818","Z91.89","I82.90","Z68.41","H66.90","B00.1","Z12.39","J06.9","L02.91","M54.16","M47.816","I48.2","H91.21","Z01.411","Z63.0","M76.51","I48.21","R60.0","R87.619"],"date":["2021-12-08","2021-12-08","2020-10-05","2020-10-21","2021-05-12","2021-05-12","2021-09-11","2021-09-11","2021-09-11","2021-09-11","2019-04-12","2021-07-23","2019-02-07","2019-02-07","2019-05-01","2020-02-06","2020-02-06","2019-07-18","2020-02-25","2021-04-19","2020-04-24","2021-02-08","2020-08-03","2020-06-09","2020-08-28","2021-07-01","2021-04-05","2021-04-14","2021-04-05","2021-07-28","2021-07-28","2020-10-05","2020-05-18","2020-02-24","2020-06-18","2020-08-03","2020-08-03","2020-08-03","2021-01-13","2021-03-03","2021-03-03","2021-03-03","2021-04-01","2021-04-01","2021-07-23","2021-07-23","2021-09-11","2021-09-11","2021-09-27","2020-11-17","2020-11-17","2020-11-17","2020-11-17","2020-11-17","2020-11-17","2020-11-17","2021-12-22","2020-06-02","2020-08-28","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2021-02-04","2021-12-14","2021-07-01","2019-01-02","2021-07-01","2019-01-02","2019-07-31","2019-07-31","2019-07-31","2019-04-18","2019-09-10","2019-09-10","2021-07-01","2019-09-10","2021-07-01","2019-09-10","2020-05-18","2021-12-14","2021-12-14","2019-01-24","2019-01-24","2020-07-09","2020-04-15","2020-04-15","2020-08-12","2020-12-22","2021-04-07","2021-09-13","2021-09-13","2019-01-18","2019-03-01","2019-06-07","2020-10-09","2021-04-14","2021-07-01","2021-07-01","2020-07-09"],"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":[]},{"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":[["","67877022310","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","180","Select","Select",""],["","","MELATONIN","TAB 5MG","","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00093406801","PRAZOSIN","CAP 2MG","30","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","","BUSPIRONE","TAB 5MG","","Select","Select",""],["","","HYDROXYZ","CAP 25MG","","Select","Select",""],["","39423011048","FLORAJEN","CAP ACIDOPHI","30","Select","Select",""],["","","SV","TAB 5MG","","Select","Select",""],["","65862069730","VENLAFAXINE","CAP 150MG ER","30","Select","Select",""],["","68645051054","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","43547026810","ROPINIROLE","TAB 0.25MG","60","Select","Select",""],["","70010000201","COLCHICINE","TAB 0.6MG","20","Select","Select",""],["","16714004107","ALLOPURINOL","TAB 100MG","30","Select","Select",""],["","43598065530","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","68382032010","POT  CHLORIDE","TAB 10MEQ ER","30","Select","Select",""],["","43547040211","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","25","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","00832532411","POT  CL MICRO","TAB 10MEQ ER","30","Select","Select",""],["","00143314250","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","","ALLERGY","TAB 180MG","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","","FEXOFENADINE","TAB 180MG","","Select","Select",""],["","","DICLOFENAC","GEL 0.01","","Select","Select",""],["","","VOLTAREN","GEL 0.01","","Select","Select",""],["","","ACYCLOVIR","TAB 800MG","","Select","Select",""],["","","NITROGLYCERN","SUB 0.4MG","","Select","Select",""],["","","CLINDAMYCIN","CAP 300MG","","Select","Select",""],["","49035023814","EQ","CAP SOFTENER","28","Select","Select",""],["","00904645780","DOK","CAP 100MG","30","Select","Select",""],["","59148000813","ABILIFY","TAB 10MG","30","Select","Select",""],["","69315013601","BENZTROPINE","TAB 0.5MG","90","Select","Select",""],["","13668021830","ARIPIPRAZOLE","TAB 10MG","30","Select","Select",""],["","66758017092","KLOR-CON","TAB 10MEQ ER","30","Select","Select",""],["","68645055054","LISINOPRIL","TAB 2.5MG","30","Select","Select",""],["","59741030124","HYDROCORT","SUP 25MG","28","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","30","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","00904198280","MAPAP","TAB 325MG","30","Select","Select",""],["","00713050312","ANUCORT-HC","SUP 25MG","28","Select","Select",""],["","43386006019","GAVILYTE-C","SOL ","4000","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":""}]}]}