{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TANISA   R TURNER","gend":1,"add":"549 HAW PATCH ROAD","city":"FERRUM","state":"VA","zip":"24088-9998","dob":"1973-05-08","age":"","mstatus":"","insh":"20053820*01","cliId":"","pno":"276\/358-2556","cno":"276\/358-2556","email":"","ename":"","eno":"","pphy":"THORNTON, ALLISON DO","ppno":"540\/484-4800","pcpadd":"390 SOUTH MAIN STREET","pcpcity":"ROCKY MOUNT","pcpstate":"VA","pcpzip":24151,"pcpcounty":"","pcpid":"","pcpname":"Inpatient Carilion Giles Community Hospital","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/921-5606","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F43.10","F31.81","F31.9","F51.05","F41.1","N92.6","R23.2","F32.1","Z13.220","R63.4","F51.04","NO DATA","H11.89","H52.13","F31.4","F32.89","F17.210","Z53.29"],"date":["2022-05-10","2022-05-10","2022-09-01","2022-06-28","2022-06-28","2020-08-24","2020-08-24","2022-02-09","2022-04-15","2022-04-15","2022-04-15","2022-01-11","2021-04-15","2021-04-15","2022-01-11","2022-01-11","2022-01-11","2022-01-11"],"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":[["","00006033530","BELSOMRA","TAB 20MG","30","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","13668000805","ZOLPIDEM","TAB 10MG","15","Select","Select",""],["","69584009250","BUSPIRONE","TAB 10MG","90","Select","Select",""],["","63402030830","LATUDA","TAB 80MG","90","Select","Select",""],["","00228142203","LAMOTRIGINE","TAB 100MG ER","30","Select","Select",""],["","43547030503","ARIPIPRAZOLE","TAB 15MG","90","Select","Select",""],["","00115180301","HYDROXYZ","CAP 25MG","30","Select","Select",""],["","59651017301","DOXEPIN","CAP 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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}