{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AMY CLEVENGER","gend":1,"add":"416 E 12TH ST","city":"BUENA VISTA","state":"VA","zip":"24416-9998","dob":"1970-01-08","age":"","mstatus":"","insh":"20066611*01","cliId":"","pno":"","cno":"","email":"","ename":"","eno":"","pphy":"MARSH, JOHN O MD","ppno":"540\/887-2627","pcpadd":"40 CHERRY GROVE ROAD","pcpcity":"MIDDLEBROOK","pcpstate":"VA","pcpzip":24459,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/886-2726","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z12.39","M79.89","E11.9","M62.81","N31.1","R39.81","R50.9","R41.82","R60.0","I50.9","I10.","F41.8","G40.909","Z68.41","J45.909","G00.9","J44.9","R09.82","M06.9","R94.31","U07.1","G03.8","E83.42","J20.8","J96.01","NO DATA","G93.1","J45.20","E66.9","Z68.34","E87.6","F41.9","F17.210","F17.290","F15.10","M06.00","Z51.81","R21.","M19.029","Z79.899","R27.0","R41.89","G93.89","G93.40","M13.80","M19.022","A41.9","Z20.822","F34.1","F41.1","E55.9","F17.200","M06.021","M19.021","D50.9","R41.3","F19.20","L08.9"],"date":["2020-06-29","2020-06-29","2021-09-16","2022-01-05","2022-01-05","2022-01-05","2021-09-15","2021-09-15","2022-07-20","2022-07-20","2022-07-20","2022-07-20","2022-07-20","2022-04-13","2022-07-20","2022-07-20","2022-07-20","2022-07-20","2022-07-20","2021-09-15","2021-09-19","2021-09-17","2021-09-16","2022-03-14","2021-09-19","2021-09-19","2021-09-16","2021-09-19","2021-09-19","2021-09-16","2021-09-16","2021-09-19","2021-09-16","2021-09-16","2021-09-16","2022-06-15","2021-12-03","2022-09-21","2022-04-20","2022-06-15","2021-05-05","2021-05-05","2021-05-05","2021-09-19","2022-11-21","2022-11-21","2021-09-15","2021-12-02","2020-09-25","2020-09-25","2020-06-26","2020-06-26","2022-09-22","2022-09-22","2022-09-28","2020-09-08","2020-09-08","2022-07-20"],"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":[["","72205000490","ROSUVASTATIN","TAB 20MG","28","Select","Select",""],["","23155010210","METFORMIN","TAB 500MG","28","Select","Select",""],["","50228011410","FLUOXETINE","CAP 20MG","28","Select","Select",""],["","62175011843","OMEPRAZOLE","CAP 20MG","28","Select","Select",""],["","00093729505","CARVEDILOL","TAB 12.5MG","56","Select","Select",""],["","55111052130","ATOMOXETINE","CAP 40MG","28","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","59651034830","LEFLUNOMIDE","TAB 10MG","28","Select","Select",""],["","63323012310","METHOTREXATE","INJ 25MG\/ML","12","Select","Select",""],["","43547035611","LISINOPRIL","TAB 40MG","28","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","56","Select","Select",""],["","29300024210","AMLODIPINE","TAB 5MG","10","Select","Select",""],["","16729013616","CLONAZEPAM","TAB 0.5MG","60","Select","Select",""],["","08290309626","1ML","MIS 25GX5\/8\"","15","Select","Select",""],["","69315011610","FUROSEMIDE","TAB 20MG","12","Select","Select",""],["","00487030101","ALBUTEROL","NEB 0.63MG\/3","120","Select","Select",""],["","69315012710","FOLIC","TAB 1000MCG","28","Select","Select",""],["","65862064163","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00054472831","PREDNISONE","TAB 5MG","120","Select","Select",""],["","00185005501","METOLAZONE","TAB 5MG","7","Select","Select",""],["","68462047205","POT  CL MICRO","TAB 20MEQ ER","60","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","50","Select","Select",""],["","51672127401","BETAMETH","CRE 0.0005","15","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","14","Select","Select",""],["","63824000886","MUCINEX","TAB 600MG ER","20","Select","Select",""],["","50428152314","CVS","TAB 325MG","30","Select","Select",""],["","50428028842","VITAMIN","TAB 500MG","30","Select","Select",""],["","49483034010","ACETAMIN","TAB 325MG","60","Select","Select",""],["","59651039105","BUSPIRONE","TAB 10MG","60","Select","Select",""],["","43547028211","ESCITALOPRAM","TAB 20MG","28","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":""}]}]}