{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HANNAH   J WILBORN","gend":1,"add":"4331 OLD RICHMOND RD","city":"BLACKSTONE","state":"VA","zip":"23824-9998","dob":"1995-08-10","age":"","mstatus":"","insh":"20054028*01","cliId":"","pno":"434\/321-9388","cno":"434\/321-9388","email":"","ename":"","eno":"","pphy":"MARSTON, JONATHAN E MD","ppno":"434\/645-9191","pcpadd":"12522 W COLONIAL TRAIL HWY","pcpcity":"CREWE","pcpstate":"VA","pcpzip":23930,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/645-1859","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z91.09","F41.9","F31.89","D22.62","D48.5","L70.0","L74.510","L74.512","L74.513","L90.5","F43.12","F41.1","F39.","F90.0","Z30.09","F41.8","Z32.02","B02.9","M54.2","M79.604","M79.605","Z03.818","M79.7","R42.","K58.9","K58.2","G47.33","J30.81","R09.82","J30.89","K59.04","K21.9","R13.19","R13.10","F31.9","Z30.431","M54.6","M25.552","M25.551","F43.10","F43.23","R74.8","S06.0X9S","H57.9","F33.1","J30.1","J45.20","G89.29","Z00.00","E53.8","R20.2","F32.9","T30.0","Z51.81","N91.1","M41.80","R00.0","M25.562","J01.10","Z11.3","Z30.430","Z87.820","G89.4","F33.0","F84.0","R89.9","R51.9","L81.0","L68.0","E78.00","R14.0","R79.89","K59.00","V58.89","R09.81","K21.0","L23.9","L21.8","L29.8","L20.84","H69.83","N92.0","N92.6","M35.7","G47.00","M70.61","B34.9","R68.89","Z71.89","M79.609","H93.8X3","Z20.828","J01.00"],"date":["2022-08-19","2021-02-12","2020-11-24","2020-08-24","2020-08-24","2021-09-01","2021-06-11","2021-03-23","2021-03-23","2021-09-01","2022-10-17","2022-10-17","2021-08-05","2021-08-05","2021-03-19","2021-03-19","2022-01-07","2021-07-24","2022-07-28","2022-01-27","2022-01-27","2021-09-27","2022-07-21","2021-10-04","2021-10-04","2022-03-17","2022-09-27","2020-04-08","2020-04-08","2022-09-14","2020-05-01","2020-08-18","2020-05-01","2020-08-18","2020-12-22","2021-04-30","2021-06-25","2021-06-25","2021-06-25","2022-05-09","2022-04-18","2022-08-25","2022-11-16","2022-11-16","2022-11-22","2020-02-24","2020-01-20","2021-10-28","2022-03-01","2021-06-24","2021-06-24","2021-06-24","2021-06-24","2021-07-02","2022-01-07","2022-07-28","2020-05-04","2020-05-04","2021-01-30","2021-04-02","2021-04-02","2022-08-24","2022-08-24","2022-05-09","2022-05-09","2022-06-08","2022-06-17","2021-09-01","2021-06-11","2020-02-18","2020-02-18","2020-01-03","2020-01-03","2020-02-18","2020-02-18","2020-08-18","2020-12-09","2021-03-23","2021-03-23","2021-03-23","2021-04-28","2021-09-16","2021-10-28","2022-03-17","2022-03-17","2022-03-17","2022-09-13","2022-09-13","2020-02-24","2021-02-12","2021-02-12","2021-09-09","2021-09-09"],"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":[["","00591079410","DICYCLOMINE","CAP 10MG","180","Select","Select",""],["","43547028211","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","59651039360","BUSPIRONE","TAB 30MG","45","Select","Select",""],["","68180035305","SERTRALINE","TAB 100MG","45","Select","Select",""],["","67877024201","QUETIAPINE","TAB 25MG","30","Select","Select",""],["","65862022801","LAMOTRIGINE","TAB 100MG","30","Select","Select",""],["","16714089902","FEXOFENADINE","TAB 180MG","30","Select","Select",""],["","00555077902","MEDROXYPR","TAB 10MG","10","Select","Select",""],["","68180032002","BUPROPN","TAB 300MG XL","30","Select","Select",""],["","00603020922","MAG","TAB 400MG","90","Select","Select",""],["","51672421801","DOXEPIN","CAP 25MG","60","Select","Select",""],["","13107003105","MIRTAZAPINE","TAB 15MG","60","Select","Select",""],["","69097015815","MELOXICAM","TAB 7.5MG","60","Select","Select",""],["","07610003220","VITAMIN","TAB 100MG","30","Select","Select",""],["","00093738605","VENLAFAXINE","CAP 150MG ER","30","Select","Select",""],["","70000036105","24HR","TAB 180MG","30","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","18","Select","Select",""],["","23155060701","GLYCOPYRROL","TAB 2MG","60","Select","Select",""],["","00299491015","DIFFERIN","GEL 0.001","15","Select","Select",""],["","65862064169","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","37000029417","ALIGN","CAP 4MG","42","Select","Select",""],["","43386016106","MISOPROSTOL","TAB 200MCG","1","Select","Select",""],["","45802011859","MOMETASONE","SOL 0.001","60","Select","Select",""],["","68462040355","ADAPALENE","GEL 0.001","45","Select","Select",""],["","54092038301","ADDERALL","CAP 10MG","30","Select","Select",""],["","45802046564","KETOCONAZOLE","SHA 0.02","120","Select","Select",""],["","67877012440","SILVER","CRE 0.01","60","Select","Select",""],["","57664033788","AMPHET\/DEXTR","CAP 10MG ER","30","Select","Select",""],["","68382066205","SPIRONOLACT","TAB 100MG","90","Select","Select",""],["","65862044930","VALACYCLOVIR","TAB 1GM","21","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","00555902542","JUNEL","TAB ","21","Select","Select",""],["","62175013643","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","65862086001","FAMOTIDINE","TAB 40MG","60","Select","Select",""],["","65162089809","ARIPIPRAZOLE","TAB 10MG","30","Select","Select",""],["","69230030001","ALLERGY","TAB 180MG","30","Select","Select",""],["","61314032001","OLOPATADINE","SPR 0.006","30","Select","Select",""],["","51991081403","AZELASTINE","SPR 0.001","30","Select","Select",""],["","68462024805","RANITIDINE","TAB 150MG","60","Select","Select",""],["","00456120330","LINZESS","CAP 72MCG","30","Select","Select",""],["","51862000706","MICROGESTIN","TAB 44581","21","Select","Select",""],["","68462013281","NORETH\/ETHIN","TAB 44581","21","Select","Select",""],["","00023114501","BOTOX","INJ 100UNIT","1","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":""}]}]}