{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOSEPH   D ARNOLD","gend":0,"add":"1151 GLENDALE RD APT 22","city":"GALAX","state":"VA","zip":"24333-9998","dob":"1974-04-11","age":"","mstatus":"","insh":"20038934*01","cliId":"","pno":"276\/266-0947","cno":"","email":"","ename":"","eno":"","pphy":"WARREN, JAIME NP","ppno":"276\/773-2063","pcpadd":"217 S INDEPENDENCE AVENUE","pcpcity":"INDEPENDENCE","pcpstate":"VA","pcpzip":24348,"pcpcounty":"","pcpid":"","pcpname":"DLP TWIN COUNTY PHYSICIAN PRACTICES LLC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"276\/773-2118","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K08.89","U07.1","N20.0","F34.1","E78.2","K21.9","K64.9","K04.01","R68.84","G89.18","R22.0","E78.5","F41.9","Z87.442","Z88.5","Z79.899","Z87.891","Z72.89","R10.9","K02.9","I10.","T78.40XA","Z12.11","Z88.8","K03.81","K04.7","F33.1","R00.0","F51.05","J03.90"],"date":["2020-07-26","2020-12-15","2021-06-24","2021-03-02","2021-03-02","2021-03-02","2021-03-02","2021-11-08","2020-03-23","2020-03-02","2020-03-02","2020-03-02","2020-03-02","2020-06-23","2021-11-08","2021-11-08","2020-03-02","2020-03-02","2020-12-15","2020-03-02","2020-08-18","2020-08-18","2020-08-18","2021-11-08","2021-11-08","2020-06-17","2019-12-06","2019-02-28","2019-02-28","2019-04-01"],"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":[["","00093078701","ATENOLOL","TAB 25MG","30","Select","Select",""],["","69315031228","PROCTO-MED","CRE HC 2.5%","28","Select","Select",""],["","16729017217","AMITRIPTYLIN","TAB 25MG","30","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","00093720110","PRAVASTATIN","TAB 20MG","30","Select","Select",""],["","49281041950","FLUZONE","INJ 2019-20","0","Select","Select",""],["","","TAMSULOSIN","CAP 0.4MG","","Select","Select",""],["","","PENICILLN","TAB 500MG","","Select","Select",""],["","49502010202","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","","IBUPROFEN","TAB 600MG","","Select","Select",""],["","00143928501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","64980032430","PROCTOZONE","CRE -HC 2.5%","30","Select","Select",""],["","68645014059","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","","CLINDAMYCIN","CAP 300MG","","Select","Select",""],["","","OMEPRAZOLE","CAP 20MG DR","","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","","ONDANSETRON","TAB 4MG","","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","28","Select","Select",""],["","65162025350","RANITIDINE","TAB 150MG","60","Select","Select",""],["","59741030124","HYDROCORT","SUP 25MG","12","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":""}]}]}