{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARCIA   D MCCLENNY","gend":1,"add":"315 FOREST PINES RD APT C","city":"FRANKLIN","state":"VA","zip":"23851-9998","dob":"1958-07-23","age":"","mstatus":"","insh":"20068157*01","cliId":"","pno":"434\/594-8714","cno":"434\/594-8714","email":"","ename":"","eno":"","pphy":"BROCKINGTON, RICKY NP","ppno":"757\/562-2158","pcpadd":"102 FAIRVIEW DR STE B","pcpcity":"FRANKLIN","pcpstate":"VA","pcpzip":23851,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/516-8019","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.5","J02.9","I10.","R11.0","F32.9","K21.9","R39.81","M19.91","Z74.09","NO DATA","E87.6","K91.89","N17.0","K56.7","E43.","E87.2","E87.1","Z99.2","F17.210","Z79.82","E83.39","E83.52","Z48.815","I12.0","N18.6","D63.1","F41.9","L50.5","R79.89","L29.9","R10.11","K44.9","E04.0","E55.9","K43.0","K43.2","K66.0","H92.02","K62.5","K57.30","R19.4","D50.0","R10.9","K82.8","Z68.31","Z79.899","Z88.8","N17.9","R60.9","N25.9","K65.1","Z68.30","K63.1","Z98.890","R07.9","H16.223","H11.32","Z01.812","Z20.822","Z90.49","Z79.890","R73.09","H69.93","H92.09","K92.1","K64.0","Z01.818"],"date":["2022-10-20","2021-01-25","2022-04-22","2022-03-08","2021-07-21","2022-04-22","2022-10-01","2022-10-01","2022-10-01","2022-02-17","2020-09-23","2020-09-23","2020-09-23","2020-09-23","2020-09-23","2020-10-08","2020-10-08","2020-09-30","2022-03-08","2022-03-08","2020-09-23","2020-10-08","2020-11-04","2020-11-04","2020-11-04","2020-11-04","2022-06-10","2021-04-01","2021-04-01","2021-04-01","2022-03-08","2022-03-08","2022-06-16","2022-06-16","2022-09-26","2022-09-30","2022-09-30","2021-01-25","2022-03-08","2022-02-17","2022-02-17","2022-02-17","2022-03-08","2022-03-18","2022-07-11","2022-03-08","2020-09-04","2020-10-30","2020-10-08","2020-10-08","2020-08-05","2020-08-10","2020-09-11","2020-09-11","2020-09-24","2022-04-18","2022-04-18","2022-03-04","2022-03-04","2022-03-08","2022-03-08","2021-01-21","2021-05-12","2021-05-12","2021-06-23","2021-07-01","2020-08-10"],"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":[["","00046110811","PREMPRO","TAB 0.625-5","28","Select","Select",""],["","23155050105","HYDROXYZ","TAB 25MG","45","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","12","Select","Select",""],["","33342017807","OLMESA","TAB 5MG","180","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","65862001705","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","59762040101","SUCRALFATE","TAB 1GM","28","Select","Select",""],["","62175011843","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","43547028110","ESCITALOPRAM","TAB 10MG","90","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","00406324301","HYDROMORPHON","TAB 2MG","24","Select","Select",""],["","66685100100","AMOX\/K","TAB 875-125","20","Select","Select",""],["","68382002101","VENLAFAXINE","TAB 75MG","90","Select","Select",""],["","68382004001","PROMETHAZINE","TAB 12.5MG","30","Select","Select",""],["","00143312601","DICYCLOMINE","CAP 10MG","10","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","3","Select","Select",""],["","00093117701","NEOMYCIN","TAB 500MG","6","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":""}]}]}