{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NANCY   R PLASTER","gend":1,"add":"11983 WYTHE ROAD","city":"COEBURN","state":"VA","zip":"24230-9998","dob":"1962-10-16","age":"","mstatus":"","insh":"20045360*01","cliId":"","pno":"276\/807-7568","cno":"","email":"","ename":"","eno":"","pphy":"NIDA, MAURICE E DO","ppno":"276\/679-0321","pcpadd":"295 WHARTON LN","pcpcity":"NORTON","pcpstate":"VA","pcpzip":24273,"pcpcounty":"","pcpid":"","pcpname":"WELLMONT MEDICAL ASSOCIATES INC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"276\/679-6498","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M17.11","M23.91","M75.121","Z01.818","Z20.828","S83.241A","I10.","M17.10","Z01.812","N95.0","J44.9","R07.89","R10.11","E78.2","K21.9","M25.561","R60.9","M54.9","F41.9","L03.115","Z12.31","H60.8X3","K59.00","M17.12","G47.33","R09.02","F51.12","G47.52","Z96.652","F17.200","R73.09","Z12.4","K21.0","R07.9","G89.18","M25.562","E66.01","G47.30","Z99.81","R06.00","M17.0","G89.29","Z47.89","R60.1","R06.83","M25.662","Z20.822","R94.2","Z68.42","J44.1","R73.9","J32.9","R43.1","L40.9","Z01.810","Z47.1"],"date":["2021-10-21","2021-10-21","2020-08-17","2021-06-23","2020-11-09","2020-11-13","2021-08-31","2021-07-01","2021-10-19","2021-10-19","2021-12-01","2020-01-26","2020-01-26","2021-08-31","2020-12-09","2021-04-28","2021-04-28","2021-04-28","2020-04-28","2020-04-28","2021-08-31","2020-04-28","2020-04-28","2021-06-30","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-21","2021-08-31","2021-08-31","2021-08-31","2019-01-18","2019-01-18","2021-06-30","2021-07-19","2021-08-08","2021-08-08","2021-08-08","2021-08-08","2020-02-17","2021-04-28","2021-03-15","2021-03-15","2021-05-20","2021-07-19","2021-06-23","2021-03-15","2021-05-20","2019-03-01","2019-09-04","2019-09-04","2019-09-04","2019-09-04","2020-10-29","2021-10-21"],"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":[["","","TIZANIDINE"," TIZANIDINE ","60","Select","Select",""],["","","BUPROPN"," BUPROPN ","30","Select","Select",""],["","","NAPROXEN"," NAPROXEN ","60","Select","Select",""],["","","POT  CHLORIDE"," POT  CHLORIDE","30","Select","Select",""],["","","FUROSEMIDE"," FUROSEMIDE ","60","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","30","Select","Select",""],["","","LISINOPRIL"," LISINOPRIL ","60","Select","Select",""],["","","PROVENTIL"," PROVENTIL ","7","Select","Select",""],["","","SM"," SM ","120","Select","Select",""],["","","ADVAIR"," ADVAIR ","60","Select","Select",""],["","","FISH"," FISH ","120","Select","Select",""],["","","AMOX\/K"," AMOX\/K ","20","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","10","Select","Select",""],["","","CHANTIX"," CHANTIX ","53","Select","Select",""],["","","PANTOPRAZOLE"," PANTOPRAZOLE ","30","Select","Select",""],["","","TRIAMCINOLON"," TRIAMCINOLON ","60","Select","Select",""],["","","NEO\/POLY\/HC"," NEO\/POLY\/HC ","10","Select","Select",""],["","","FLUTIC\/SALME"," FLUTIC\/SALME ","60","Select","Select",""],["","","OMEGA-3-ACID"," OMEGA-3-ACID ","120","Select","Select",""],["","","SYMBICORT"," SYMBICORT ","10","Select","Select",""],["","","EUFLEXXA"," EUFLEXXA ","12","Select","Select",""],["","","ROSUVASTATIN","TAB 20MG","","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","","ALBUTEROL","NEB 0.00083","","Select","Select",""],["","","POLYETH","POW 3350 NF","","Select","Select",""],["","","MELOXICAM","TAB 15MG","","Select","Select",""],["","","CLINDAMYCIN","CAP 150MG","","Select","Select",""],["","","PHENTERMINE","CAP 15MG","","Select","Select",""],["","","DICLOFEN","TAB 50MG","","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","","TRAMADOL","TAB 50MG","","Select","Select",""],["","","CELECOXIB","CAP 100MG","","Select","Select",""],["","","SUCRALFATE","TAB 1GM","","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":""}]}]}