{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KRISTA   D PATTERSON","gend":1,"add":"2648 MISTWOOD FOREST DR","city":"CHESTER","state":"VA","zip":"23831-9998","dob":"1981-02-17","age":"","mstatus":"","insh":"2153119*01","cliId":"","pno":"804\/379-1470","cno":"","email":"","ename":"","eno":"","pphy":"CELLA, CAROLINE P MD","ppno":"804\/320-1333","pcpadd":"1471 JOHNSTON WILLIS DRIVE","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23235","pcpcounty":"","pcpid":"","pcpname":"Primary Health Group - Johnston-Willis","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/320-5606","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E03.9","R53.83","R63.5","E55.9","R44.2","R51.9","F32.1","G43.009","M54.5","K21.9","R43.8","R45.86","E66.3","M79.7","G47.00","M54.16","R42.","R00.2","Z00.00","M25.50","M65.342","K58.2","J45.20","J30.9","Z68.28","Z01.419","N89.8","J45.909","R10.2","B37.3","NO DATA","N30.00","G43.019","M13.0","M24.9","R06.02","Z68.27","N92.0","M17.0","R00.1","G43.909","Z09.","M25.551","M79.671"],"date":["2021-10-04","2021-10-04","2021-10-04","2021-06-07","2021-08-13","2020-12-21","2021-12-21","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2021-12-13","2021-12-13","2021-12-13","2020-01-23","2020-03-10","2021-09-01","2020-08-31","2020-08-31","2020-08-31","2021-09-01","2020-08-31","2021-09-01","2021-01-19","2021-03-30","2021-01-19","2021-04-27","2021-04-27","2021-11-06","2020-02-11","2021-01-04","2020-12-28","2020-12-28","2021-09-01","2020-02-28","2020-06-19","2021-09-13","2020-06-21","2020-11-02","2020-07-14","2021-09-13","2021-09-13"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","69097012312","TOPIRAMATE","TAB 50MG","60","Select","Select",""],["","71921017061","SUMATRIPTAN","SPR 20MG\/ACT","6","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","90","Select","Select",""],["","00046087221","PREMARIN","CRE 0.625MG","30","Select","Select",""],["","69097086107","ZONISAMIDE","CAP 100MG","180","Select","Select",""],["","71093011205","GABAPENTIN","TAB 800MG","270","Select","Select",""],["","60505328006","LEVETIRACETA","TAB 500MG ER","270","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","47781064390","LEVOTHYROXIN","TAB 50MCG","90","Select","Select",""],["","00456045801","ARMOUR","TAB 30MG","30","Select","Select",""],["","00591292754","LEVALBUTEROL","AER 45\/ACT","15","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","76385012350","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","65862044930","VALACYCLOVIR","TAB 1GM","4","Select","Select",""],["","72305005030","EUTHYROX","TAB 50MCG","90","Select","Select",""],["","00172392570","DIAZEPAM","TAB 2MG","1","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","63402051001","XOPENEX","AER ","15","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":""}]}]}