{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SUSAN COSTELLO","gend":1,"add":"238 HACKBERRY DR","city":"STEPHENS CITY","state":"VA","zip":"22655-9998","dob":"1955-12-26","age":"","mstatus":"","insh":"20054331*01","cliId":"","pno":"703\/622-2876","cno":"703\/622-2876","email":"","ename":"","eno":"","pphy":"BAGRI, HARJIT MD","ppno":"540\/665-0084","pcpadd":"2505 VALLEY AVE","pcpcity":"WINCHESTER","pcpstate":"VA","pcpzip":22601,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/665-9569","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M81.0","D72.1","J30.9","I10.","J96.10","L50.8","J44.9","Z78.9","F41.1","D50.9","T78.40XA","M25.552","Z47.89","J45.50","V54.12","J43.9","K21.9","E03.9","Z23.","M54.5","M54.17","M47.817","M51.37","J96.11","J43.2","J30.2","E78.2","E03.8","Z91.09","S72.002A","T81.41XA","B95.61","Z68.26","G56.01","M46.1","M25.559","M54.2","M25.519","M25.539","M25.569","V54.13","Z74.09","G89.18","Z99.81","E78.5","F41.8","D50.0","J98.4","R10.11","M54.16","S72.009A","R53.81","T84.612A","Z45.2","F32.9","F41.9","Z79.2","Z79.82","NO DATA","M79.605","M79.604","J96.12","Z01.818","Z12.11","K22.2","R12.","R13.19","K44.9","R26.89","R26.9"],"date":["2022-02-21","2020-05-14","2020-09-14","2022-10-12","2020-09-14","2021-07-21","2022-10-12","2021-11-10","2021-11-10","2022-10-12","2020-02-14","2020-03-19","2020-03-19","2022-10-12","2022-09-23","2020-09-14","2022-10-12","2020-09-14","2022-10-12","2020-10-29","2021-01-15","2020-10-29","2021-02-24","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-02-21","2020-01-08","2020-01-28","2020-01-28","2020-01-28","2020-03-05","2020-07-02","2020-07-02","2020-07-02","2020-07-02","2020-07-02","2020-07-02","2020-01-09","2022-02-21","2020-01-07","2020-07-29","2020-01-06","2020-01-07","2020-01-06","2020-02-14","2020-08-26","2020-09-18","2022-09-23","2020-01-09","2020-01-10","2020-01-10","2020-01-10","2020-01-10","2020-01-10","2020-01-10","2022-10-12","2020-07-29","2020-07-29","2022-01-26","2020-08-22","2020-08-26","2020-08-26","2020-08-26","2020-08-26","2020-08-26","2022-02-21","2020-01-07"],"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":[["","60505265401","TRAZODONE","TAB 100MG","180","Select","Select",""],["","69238183107","LEVOTHYROXIN","TAB 50MCG","90","Select","Select",""],["","55111012205","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","68462020113","TELMISARTAN","TAB 80MG","90","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00310183030","FASENRA","INJ 30MG\/ML","1","Select","Select",""],["","23155050201","HYDROXYZ","TAB 50MG","90","Select","Select",""],["","31722072690","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","00955100410","ENOXAPARIN","INJ 40\/0.4ML","2","Select","Select",""],["","00597002402","COMBIVENT","AER 20-100","4","Select","Select",""],["","00378623301","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","33342004710","IRBESARTAN","TAB 75MG","30","Select","Select",""],["","00054429731","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","00093100301","BUSPIRONE","TAB 15MG","90","Select","Select",""],["","31722088490","ROSUVASTATIN","TAB 20MG","30","Select","Select",""],["","00597010061","SPIRIVA","SPR 2.5MCG","4","Select","Select",""],["","59310057922","PROAIR","AER ","26","Select","Select",""],["","00378668977","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","76204060060","IPRATROPIUM\/","SOL ALBUTER","180","Select","Select",""],["","65862090801","CELECOXIB","CAP 100MG","90","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","65862032904","ALENDRONATE","TAB 70MG","4","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","00591024005","LORAZEPAM","TAB 0.5MG","60","Select","Select",""],["","69097096507","NABUMETONE","TAB 500MG","14","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","20","Select","Select",""],["","65162010150","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","00363053112","PAIN","TAB 500MG","180","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":""}]}]}