{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AMY   D MCGLOTHLIN","gend":1,"add":"522 SOUTH MAIN ST","city":"MARION","state":"VA","zip":"24354-9998","dob":"1981-10-13","age":"","mstatus":"","insh":"20052481*01","cliId":"","pno":"276\/780-1574","cno":"276\/780-1574","email":"","ename":"","eno":"","pphy":"SOMERVELL, PAMELA M MD","ppno":"276\/496-4492","pcpadd":"319 Fifth Ave, 1st Floor","pcpcity":"SALTVILLE","pcpstate":"VA","pcpzip":24370,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"276\/496-4013","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","F15.10","F17.290","F12.90","M25.562","F31.9","F31.12","Z13.31","F41.9","F90.9","B18.2","G43.019","G25.81","F31.10","G47.00","Z79.899","R73.01","F32.9","Z79.891"],"date":["2022-10-07","2022-09-30","2022-09-30","2022-09-30","2020-02-28","2020-11-30","2020-07-21","2020-07-21","2020-07-21","2020-07-21","2020-07-21","2020-07-21","2020-03-10","2020-03-10","2020-03-10","2020-03-10","2020-03-10","2020-03-10","2020-07-07"],"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":[["","00093216568","NALOXONE","SPR ","2","Select","Select",""],["","00378876793","BUPREN\/NALOX","MIS 8-2MG","14","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","14","Select","Select",""],["","11877001140","BINAXNOW","KIT HOME TES","2","Select","Select",""],["","00781261301","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","72888001001","BACLOFEN","TAB 10MG","14","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","42571025201","CLINDAMYCIN","CAP 300MG","40","Select","Select",""],["","67877024201","QUETIAPINE","TAB 25MG","30","Select","Select",""],["","65862019201","FLUOXETINE","CAP 10MG","14","Select","Select",""],["","67877022310","GABAPENTIN","CAP 300MG","42","Select","Select",""],["","16729013616","CLONAZEPAM","TAB 0.5MG","30","Select","Select",""],["","69097012215","TOPIRAMATE","TAB 25MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00054011625","ROPINIROLE","TAB 0.25MG","30","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","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":""}]}]}