{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARY   S JOINES","gend":1,"add":"331 DOUGLAS ST APT B6","city":"MARION","state":"VA","zip":"24354-9998","dob":"1969-08-04","age":"","mstatus":"","insh":"20051977*01","cliId":"","pno":"276\/780-1976","cno":"","email":"","ename":"","eno":"","pphy":"STIEFEL, BRIAN HARRIS MD","ppno":"276\/783-7167","pcpadd":"SUITE 200 1020 TERRACE DR","pcpcity":"MARION","pcpstate":"VA","pcpzip":24354,"pcpcounty":"","pcpid":"","pcpname":"ROYAL OAK MEDICAL ASSOCIATES PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.3","L40.3","Z79.899","R07.9","R00.2","I10.","F31.9","L40.1","F31.12","K58.0","S92.351A","F41.9","K58.9","E55.9","G93.2","G43.709","I95.9","R41.9","G25.81","G47.33","L40.0","L81.4","K21.9","B34.9","R22.0","K08.89","K02.9","L30.9","H47.10","R06.83","I25.10","S92.354A","W19.XXXA","V54.16","L30.0","G47.30","F17.290","S99.921A","K04.7","H47.11","R53.83","G47.61","NO DATA","F17.200","R00.1","G43.009","R42.","E78.5","R73.9","F41.1"],"date":["2019-08-20","2020-03-05","2021-09-29","2019-12-12","2019-12-12","2022-01-03","2022-10-12","2020-07-07","2022-11-14","2021-05-06","2021-11-10","2022-11-03","2021-04-15","2021-04-15","2022-05-16","2021-04-28","2021-04-28","2021-11-19","2022-11-03","2022-03-25","2020-04-15","2019-07-01","2019-09-04","2019-09-26","2019-10-30","2019-10-30","2019-10-30","2020-10-14","2021-01-11","2021-07-28","2022-01-03","2021-09-29","2021-09-29","2021-12-21","2020-06-23","2021-09-14","2021-09-29","2021-09-29","2022-04-21","2022-02-07","2021-04-15","2021-07-28","2021-08-16","2022-01-03","2022-01-03","2022-05-16","2022-05-16","2022-07-21","2022-07-21","2022-07-21"],"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":[["","65862018601","CLINDAMYCIN","CAP 300MG","20","Select","Select",""],["","63402031230","LATUDA","TAB 120MG","30","Select","Select",""],["","29033003001","ACETAZOLAMID","CAP 500MG ER","90","Select","Select",""],["","16729017101","AMITRIPTYLIN","TAB 10MG","60","Select","Select",""],["","16729022501","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","43547035311","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","16714066201","GABAPENTIN","CAP 300MG","60","Select","Select",""],["","59762372001","ALPRAZOLAM","TAB 0.5MG","30","Select","Select",""],["","00185061501","HYDROXYZ","CAP 50MG","90","Select","Select",""],["","62175013643","OMEPRAZOLE","CAP 40MG","60","Select","Select",""],["","57664033988","AMPHET\/DEXTR","CAP 20MG ER","30","Select","Select",""],["","16714079801","SUMATRIPTAN","TAB 100MG","9","Select","Select",""],["","67877044090","ROSUVASTATIN","TAB 10MG","30","Select","Select",""],["","68382080601","TRAZODONE","TAB 100MG","30","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","54092038701","ADDERALL","CAP 20MG","30","Select","Select",""],["","33342008845","RIZATRIPTAN","TAB 10MG","10","Select","Select",""],["","31722077701","ACYCLOVIR","TAB 400MG","15","Select","Select",""],["","29300011101","LAMOTRIGINE","TAB 25MG","120","Select","Select",""],["","76385013401","NADOLOL","TAB 40MG","30","Select","Select",""],["","64764024060","AMITIZA","CAP 24MCG","60","Select","Select",""],["","69097012403","TOPIRAMATE","TAB 100MG","30","Select","Select",""],["","00254302902","LUBIPROSTONE","CAP 24MCG","60","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","00093227534","AMOX\/K","TAB 875-125","14","Select","Select",""],["","00603533715","PREDNISONE","PAK 5MG","21","Select","Select",""],["","57894006103","STELARA","INJ 90MG\/ML","1","Select","Select",""],["","16729018317","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","00002144511","TALTZ","INJ 80MG\/ML","3","Select","Select",""],["","00074204202","SKYRIZI","INJ 150DOSE","1","Select","Select",""],["","00187510001","ELIDEL","CRE 0.01","30","Select","Select",""],["","68462060935","PIMECROLIMUS","CRE 0.01","30","Select","Select",""],["","68462053435","TACROLIMUS","OIN 0.001","30","Select","Select",""],["","50222021130","PROTOPIC","OIN 0.001","30","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":""}]}]}