{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DONALD   R CARNES","gend":0,"add":"1418 11TH ST","city":"VICTORIA","state":"VA","zip":"23974-9998","dob":"1974-12-10","age":"","mstatus":"","insh":"20070077*01","cliId":"","pno":"434\/321-2379","cno":"434\/321-2379","email":"","ename":"","eno":"","pphy":"INGE, MARGARET DO","ppno":"434\/696-2165","pcpadd":"1508 K V RD","pcpcity":"VICTORIA","pcpstate":"VA","pcpzip":23974,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/696-1557","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.9","F41.0","Z63.8","F33.1","R07.89","I49.1","I35.1","I48.91","H53.462","Z86.73","I63.9","R42.","R53.1","F17.210","Z20.822","Z79.899","F32.1","F41.9","R51.9","R00.2","Z76.89","Z68.32","E78.5","I48.0","G43.011","Z23.","M10.09","Z86.711","Z79.01","F34.9","E66.9","F32.2","G43.009","R09.89","R94.31","N18.9","I51.7","I77.810","R29.898","R47.9","H53.9","Z86.79","R53.83","G93.89","F32.9","I12.9","NO DATA","F12.90","K21.9","M06.9","M10.9","M19.90","M50.30","J01.00"],"date":["2021-06-01","2021-09-21","2021-07-06","2021-09-21","2022-03-08","2022-03-08","2022-08-18","2022-09-07","2022-08-01","2022-07-05","2022-08-30","2022-11-02","2022-11-02","2022-11-02","2022-11-02","2022-03-15","2022-10-04","2022-10-04","2022-08-17","2022-03-07","2022-07-22","2022-08-30","2022-08-30","2022-08-17","2022-05-24","2021-11-17","2021-11-17","2021-11-17","2022-08-18","2021-11-17","2022-08-17","2022-04-12","2022-08-01","2022-07-13","2022-07-13","2022-08-17","2022-08-18","2022-08-18","2022-09-01","2022-09-01","2022-09-01","2022-09-01","2022-05-05","2022-08-17","2022-08-17","2022-08-17","2022-08-17","2022-08-17","2022-08-17","2022-08-17","2022-08-17","2022-08-17","2022-08-17","2022-01-14"],"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":[["","68382041205","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","50111043402","TRAZODONE","TAB 100MG","90","Select","Select",""],["","68462026290","ROSUVASTATIN","TAB 10MG","30","Select","Select",""],["","65862067799","ALPRAZOLAM","TAB 0.5MG","60","Select","Select",""],["","45963070996","METOPROL","TAB 25MG ER","15","Select","Select",""],["","00093227534","AMOX\/K","TAB 875-125","20","Select","Select",""],["","57237001999","DULOXETINE","CAP 60MG","30","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","16729013516","ALLOPURINOL","TAB 300MG","30","Select","Select",""],["","00185041505","BUPROPION","TAB 150MG SR","180","Select","Select",""],["","67877043105","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","23","Select","Select",""],["","65862014736","SUMATRIPTAN","TAB 50MG","20","Select","Select",""],["","68382013905","TOPIRAMATE","TAB 50MG","60","Select","Select",""],["","60505258008","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","00527169505","BUT\/APAP\/CAF","TAB ","24","Select","Select",""],["","70000051202","NICOTINE","DIS 21MG\/24H","14","Select","Select",""],["","65162044210","MECLIZINE","TAB 25MG","30","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","59310057922","PROAIR","AER ","8","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}