{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BARBARA   J HAIRSTON","gend":1,"add":"224 AMY AVE","city":"MARTINSVILLE","state":"VA","zip":"24112-9998","dob":"1965-07-25","age":"","mstatus":"","insh":"20051531*01","cliId":"","pno":"804\/855-8670","cno":"804\/855-8670","email":"","ename":"","eno":"","pphy":"ATIENZA, VERGEL S MD","ppno":"540\/483-5277","pcpadd":"180 FLOYD AVE","pcpcity":"ROCKY MOUNT","pcpstate":"VA","pcpzip":24151,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.1","S82.832A","S82.102A","S01.81XA","E87.6","S82.142A","S82.52XA","G93.40","R41.0","D62.","R50.9","R00.0","N82.3","S01.91XA","S61.012A","I10.","S82.892A","J44.9","G40.909","F20.9","S82.209A","V54.16","G92.","E87.1","N39.0","F13.921","K50.913","F17.210","Z88.0","Z88.6","F32.9","F41.9","S92.132A","Z01.818","R94.31","R21.","Z79.899","S82.91XA","I45.81","F17.200","F10.10","R56.9","F39.","Z72.0","M25.562","V89.2XXS","S82.142S","G89.29","Z98.890","Z87.81","Z71.89","S82.202A","S82.402A","V89.2XXD","D64.9","Z86.69","N90.89","Z86.59","V47.1XXA","M79.605","M79.604","V89.2XXA","G93.41","B96.20"],"date":["2022-09-26","2020-06-02","2020-06-01","2020-06-01","2020-06-10","2020-06-10","2020-06-07","2020-06-09","2020-06-08","2020-06-09","2020-06-07","2020-06-07","2020-07-24","2020-06-09","2020-06-09","2020-07-15","2020-06-12","2020-07-15","2021-02-22","2020-07-15","2021-05-27","2020-09-11","2020-06-02","2020-06-06","2020-07-15","2020-06-02","2020-06-02","2021-02-22","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-06-08","2020-05-01","2020-05-01","2020-06-02","2020-06-03","2020-06-03","2020-06-09","2020-07-15","2020-07-15","2020-07-15","2021-02-22","2021-02-22","2021-02-22","2021-02-22","2021-02-22","2021-02-22","2021-02-22","2020-06-02","2020-06-02","2020-06-05","2020-06-05","2020-06-09","2020-06-02","2020-06-12","2020-06-01","2020-06-08","2020-06-08","2020-06-12","2020-06-12","2020-06-12"],"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":[["","00093100305","BUSPIRONE","TAB 15MG","56","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","28","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","59310030480","QVAR","AER 80MCG","11","Select","Select",""],["","10006073043","VITAMIN","TAB 1000MCG","28","Select","Select",""],["","51672411101","PHENYTOIN","CAP 100MG","56","Select","Select",""],["","65862019399","FLUOXETINE","CAP 20MG","84","Select","Select",""],["","40985022380","SENTRY","TAB ","28","Select","Select",""],["","59762531001","PRAZOSIN","CAP 1MG","28","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","45802005911","NYSTATIN","CRE 100000","60","Select","Select",""],["","68382011605","RISPERIDONE","TAB 3MG","28","Select","Select",""],["","57664051083","MIRTAZAPINE","TAB 7.5MG","28","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","80681002000","MULTIVITAMIN","TAB ","28","Select","Select",""],["","00536479901","E-400","CAP 400UNIT","56","Select","Select",""],["","11917011823","D3","CAP 400UNIT","56","Select","Select",""],["","00536544001","VIT","CAP 400UNIT","56","Select","Select",""],["","50458060901","INVEGA","INJ 819MG","3","Select","Select",""],["","68462019001","NAPROXEN","TAB 500MG","56","Select","Select",""],["","67877022305","GABAPENTIN","CAP 300MG","168","Select","Select",""],["","00904264172","CERTAVITE\/","TAB ANTIOXID","28","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","20","Select","Select",""],["","00955100410","ENOXAPARIN","INJ 40\/0.4ML","4","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":""}]}]}