{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WHITLEY   A OLIVER","gend":1,"add":"306 DAIRY ST APT S38","city":"COVINGTON","state":"VA","zip":"24426-9998","dob":"1995-01-15","age":"","mstatus":"","insh":"2129751*01","cliId":"","pno":"540\/691-3866","cno":"540\/691-3866","email":"","ename":"","eno":"","pphy":"HENDERSON, ROBERT J DO","ppno":"540\/862-6750","pcpadd":"SUITE 800 200 ARH LANE","pcpcity":"COVINGTON","pcpstate":"VA","pcpzip":24426,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/862-3742","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F60.3","J01.80","B96.89","Z72.0","F43.10","J30.2","J30.81","Z20.822","J02.9","J45.909","L02.92","R35.0","V62.84","R11.2","K21.9","N89.8","B86.","R10.9","O03.4","Z3A.00","R10.2","Z20.2","N93.9","O03.1","S13.4XXA","S00.03XA","S80.01XA","R51.9","S00.83XA","W17.89XA","A56.09","A54.9","R82.90","B37.3","R30.0","R10.13","R42.","E86.0","N92.6","R10.84","M54.5","Z87.59","Z34.90","A56.02","Z11.3","Z72.51","K59.00","K64.4","J06.9","J01.00","K92.1","Z87.891","J10.1","J32.0","J30.1","R49.9","K64.8","J30.9","R49.0","J30.5","F31.9","G43.909","Z30.9","M25.50","J38.2","J32.9","R13.10","S42.292A","W18.39XA","O72.2","Z30.430","Z30.431","R05.9","Z87.440","H10.13","Z01.419","Z30.432","F31.12","O26.891","U07.1","R68.83","NO DATA","R10.30","F17.200","N76.0","Z68.32","E66.9","K64.9","K58.1","G43.509","E53.8","R53.81"],"date":["2021-06-10","2020-09-15","2021-04-08","2020-09-15","2022-01-27","2022-11-09","2022-11-09","2022-06-24","2022-06-24","2022-11-10","2022-11-10","2022-11-10","2020-03-31","2022-10-19","2022-09-14","2021-05-13","2021-02-17","2021-02-17","2021-05-01","2021-05-01","2021-01-16","2022-02-06","2021-05-01","2021-05-01","2021-09-13","2021-09-13","2021-09-13","2022-11-17","2021-09-13","2021-09-13","2022-03-24","2022-03-24","2022-03-24","2022-05-25","2022-05-25","2022-10-19","2022-10-19","2022-10-19","2021-04-08","2021-04-08","2021-07-14","2021-04-08","2021-04-08","2021-04-14","2021-04-14","2021-11-24","2022-06-30","2022-04-04","2021-11-24","2022-06-26","2022-10-19","2022-10-19","2022-01-02","2022-08-03","2022-10-06","2021-07-26","2022-06-30","2022-09-14","2022-09-14","2022-09-14","2022-03-15","2022-04-04","2021-07-14","2021-07-14","2022-04-13","2022-05-17","2022-04-13","2020-03-31","2020-03-30","2021-05-01","2021-12-02","2022-01-13","2022-04-04","2022-04-04","2022-05-17","2022-09-09","2022-09-09","2020-01-01","2021-04-08","2022-01-02","2022-01-02","2022-01-02","2022-02-06","2022-02-06","2022-03-15","2022-03-15","2022-03-15","2022-06-01","2022-06-01","2022-06-01","2022-08-25","2022-08-25"],"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":[["","64380071307","BENZONATATE","CAP 200MG","30","Select","Select",""],["","33342025866","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","00456120130","LINZESS","CAP 145MCG","30","Select","Select",""],["","00023650110","UBRELVY","TAB 100MG","20","Select","Select",""],["","00115169449","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","51991070505","ALPRAZOLAM","TAB 0.5MG","30","Select","Select",""],["","69680011225","CYANOCOBALAM","INJ 1000MCG","4","Select","Select",""],["","45802075930","PROMETHAZINE","SUP 25MG","5","Select","Select",""],["","13668042990","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","68180016006","AZITHROMYCIN","TAB 250MG","4","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","65162046935","ELURYNG","MIS ","3","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","70710122600","AMITRIPTYLIN","TAB 25MG","30","Select","Select",""],["","62559043130","HYDROCORTISO","CRE 0.025","30","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","20","Select","Select",""],["","00603459315","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00574709012","HYDROCORT","SUP 25MG","10","Select","Select",""],["","42002030268","TUCKS","PAD ","40","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","59779074702","MEDICATED","PAD PADS","100","Select","Select",""],["","00904423960","MAGNESIUM","TAB 500MG","60","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","15","Select","Select",""],["","00054414622","CLOTRIMAZOLE","TRO 10MG","56","Select","Select",""],["","00527193206","CLARITHROMYC","TAB 500MG","20","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","20","Select","Select",""],["","70069000701","OLOPATADINE","DRO 0.001","5","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","14","Select","Select",""],["","70710116101","MECLIZINE","TAB 12.5MG","20","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","10","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","00234057508","HIBICLENS","LIQ 0.04","236","Select","Select",""],["","51991081701","PROPRANOLOL","CAP 60MG ER","90","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","23155022701","ACYCLOVIR","TAB 400MG","90","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","33342008741","RIZATRIPTAN","TAB 5MG","9","Select","Select",""],["","68462030529","NORETHINDRON","TAB 0.35MG","84","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","42799080601","IVERMECTIN","TAB 3MG","20","Select","Select",""],["","59762453802","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","68180065208","DOXYCYC","CAP 100MG","28","Select","Select",""],["","45802026937","PERMETHRIN","CRE 0.05","120","Select","Select",""],["","14539067401","HYDROXYZ","CAP 25MG","90","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","59762500801","MISOPROSTOL","TAB 200MCG","4","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","90","Select","Select",""],["","63402030430","LATUDA","TAB 40MG","30","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","49281042150","FLUZONE","INJ 2021-22","0","Select","Select",""],["","45802086803","POLYETH","POW 3350 NF","510","Select","Select",""],["","16729027910","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","55111029336","SUMATRIPTAN","TAB 100MG","9","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":""}]}]}