{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"QUANTRY   C PEMBELTON III","gend":0,"add":"13410 REED ROCK ROAD","city":"AMELIA COURT HOUSE","state":"VA","zip":"23002-9998","dob":"1964-01-14","age":"","mstatus":"","insh":"20056657*01","cliId":"","pno":"434\/294-1290","cno":"434\/294-1290","email":"","ename":"","eno":"","pphy":"ARNOLD, ADAM J NP","ppno":"434\/581-3271","pcpadd":"25892 N JAMES MADISON HIGHWAY","pcpcity":"NEW CANTON","pcpstate":"VA","pcpzip":23123,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/581-1105","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G40.301","E83.42","B35.1","F32.9","E55.9","R26.2","G25.0","G40.909","F41.9","E03.9","R11.0","F17.210","K92.2","Z23.","D69.6","Z86.19","F10.10","M54.5","I10.","I95.9","J96.01","N17.9","E87.1","Z20.828","K76.6","J44.1","K70.30","F10.239","B19.20","E86.9","R56.9","M54.2","K74.60","D64.9","E87.6","K31.89","K31.819","F19.10","J44.9","R69.","F33.1","F10.20","NO DATA","M62.81","R29.3","R07.89","R07.9","M54.9","R09.02","R53.81","F10.231","M62.82","R13.10","G89.29","M54.16","G62.9","M19.90","Q27.33","Z72.0","K92.0","K92.1","K31.811","I85.00","K44.9","E11.9","R00.0","R93.89","F10.929","R10.9","Z20.822","R10.84","R60.9","R52.","N40.1","N32.81","Z87.19","Z79.899","R68.89","E78.5","R06.2","K22.6","Z86.718","G93.41","M43.10","I82.431","R47.81","R06.02","F19.239","E88.09","E83.39","F10.229","S00.81XA","S80.212A","S84.10XA","J02.9","S09.90XA","T07.XXXA","W19.XXXA","K52.9","R93.3","Z12.11","Z13.820","S22.42XA","S27.9XXA","S29.9XXA","K70.31","R94.31","R05.3","J98.09","W08.XXXA","R74.01","M21.372","R10.30","Y90.8","G40.109","Z87.39","F32.0","Z91.81","S01.512A","R53.1","I85.10","D72.819","B18.2","K29.70","R26.89","R30.0","R39.11","K62.89","M71.21","H10.45","G40.209","M79.605","R41.82","R65.10","F12.90","Q27.30","M47.816","Z12.5","D61.818","R62.7","E83.51","Z60.2"],"date":["2022-01-31","2022-08-01","2020-01-08","2020-10-28","2020-01-08","2022-06-08","2020-03-04","2022-08-01","2022-08-01","2022-06-16","2020-08-10","2022-06-15","2020-10-01","2022-06-15","2020-10-01","2020-10-01","2022-06-23","2020-10-01","2022-10-15","2020-10-30","2022-02-16","2020-10-30","2021-11-30","2020-10-28","2022-10-13","2020-10-28","2022-08-01","2022-10-15","2022-06-23","2021-11-30","2022-10-15","2022-06-08","2022-10-13","2022-01-31","2022-08-01","2022-06-23","2022-06-23","2021-11-30","2022-10-15","2021-12-10","2022-02-14","2022-10-24","2022-09-06","2022-06-08","2022-06-08","2022-10-13","2022-05-12","2022-06-15","2022-06-14","2022-04-13","2022-08-01","2022-08-01","2022-08-01","2022-10-15","2022-08-01","2022-08-01","2022-08-01","2022-08-01","2022-06-23","2020-09-14","2020-10-28","2020-09-14","2022-06-15","2022-06-23","2022-01-31","2021-11-29","2022-03-29","2022-10-15","2022-05-12","2022-06-15","2022-06-11","2022-06-14","2022-06-14","2022-10-07","2022-10-07","2021-10-21","2020-09-13","2020-10-29","2022-10-13","2020-10-30","2021-09-27","2022-01-31","2022-02-16","2022-09-06","2021-10-18","2022-02-12","2022-10-13","2022-04-13","2022-06-15","2022-06-16","2022-06-15","2022-06-15","2022-06-15","2022-06-15","2022-06-15","2022-06-16","2022-06-16","2022-06-15","2022-06-23","2022-06-23","2022-08-18","2020-02-06","2020-03-11","2020-03-11","2020-03-11","2020-09-14","2022-10-20","2022-10-13","2022-10-13","2022-06-16","2022-06-16","2022-09-06","2022-06-11","2022-06-15","2020-02-11","2020-02-11","2020-02-11","2020-08-24","2020-06-11","2022-10-15","2020-09-13","2020-09-13","2020-09-13","2021-10-21","2022-05-06","2022-06-11","2022-06-11","2022-06-11","2022-06-20","2022-07-20","2022-10-15","2022-10-15","2021-09-06","2021-11-30","2021-11-30","2020-10-28","2021-09-15","2022-01-31","2022-02-13","2022-02-13","2022-02-13","2022-02-13"],"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":[["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00054001729","PREDNISONE","TAB 10MG","21","Select","Select",""],["","65162004710","OXYCODONE","TAB 5MG","12","Select","Select",""],["","31722072610","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","00597015561","STIOLTO","AER 2.5-2.5","4","Select","Select",""],["","67877022305","GABAPENTIN","CAP 300MG","60","Select","Select",""],["","00904053961","THERA","TAB ","90","Select","Select",""],["","00228206710","OXAZEPAM","CAP 10MG","18","Select","Select",""],["","40093011539","MENS","CHW ","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00378827052","ALBUTEROL","NEB 0.00083","300","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","00093216568","NALOXONE","SPR 4MG","2","Select","Select",""],["","96295012838","MULTIVITAMIN","TAB ADLT 50+","30","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","65862024608","LEVETIRACETA","TAB 500MG","540","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","30","Select","Select",""],["","68462043518","ACAMPRO","TAB 333MG","180","Select","Select",""],["","00472033730","HYDROCORT","CRE 0.025","28","Select","Select",""],["","57237001405","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","00904674860","BISACODYL","TAB 5MG EC","2","Select","Select",""],["","60505057804","AZELASTINE","DRO 0.0005","6","Select","Select",""],["","45802086803","POLYETH","POW 3350 NF","510","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","180","Select","Select",""],["","16729031801","OXYBUTYNIN","TAB 10MG ER","90","Select","Select",""],["","43598044874","NICOTINE","DIS 21MG\/24H","28","Select","Select",""],["","72205002130","SOLIFENACIN","TAB 10MG","30","Select","Select",""],["","00469260230","MYRBETRIQ","TAB 50MG","30","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","14","Select","Select",""],["","65162036111","FOLIC","TAB 1MG","90","Select","Select",""],["","00093585105","ESCITALOPRAM","TAB 10MG","90","Select","Select",""],["","00781518210","LEVOTHYROXIN","TAB 75MCG","90","Select","Select",""],["","00603020922","MAG","TAB 400MG","90","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","90","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","90","Select","Select",""],["","72205000499","ROSUVASTATIN","TAB 20MG","90","Select","Select",""],["","00115166001","PROPRANOLOL","TAB 20MG","180","Select","Select",""],["","43547040011","CYCLOBENZAPR","TAB 10MG","90","Select","Select",""],["","00173087310","INCRUSE","INH 62.5MCG","30","Select","Select",""],["","49483048110","ASPIRIN","TAB 81MG EC","90","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":""}]}]}