{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANGELA   L LUCAS","gend":1,"add":"1212 PULASKI GILES TPKE APT 411","city":"PEARISBURG","state":"VA","zip":"24134-9998","dob":"1976-04-16","age":"","mstatus":"","insh":"2183752*01","cliId":"","pno":"540\/492-2278","cno":"540\/492-2278","email":"","ename":"","eno":"","pphy":"FREED, ELLIOT S DO","ppno":"540\/808-8913","pcpadd":"133 BOSTIC LANE","pcpcity":"PEMBROKE","pcpstate":"VA","pcpzip":24136,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/626-4353","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25.552","F11.20","F17.210","B19.20","T84.52XA","V58.89","R07.9","R60.9","R78.81","E87.6","T84.021A","X58.XXXA","Z96.642","J45.909","R26.9","Z45.2","S73.005A","M25.551","F17.219","M25.352","I26.99","B95.62","G89.18","F11.10","F13.10","F12.10","B18.2","T81.40XA","T84.021S","F19.90","Z76.89","Z86.711","I10.","J30.2","J45.20","K21.9","F41.8","I49.1","L53.9","F19.10","M24.452","M00.852","D62.","A41.89","Z65.1","Z11.59","H65.93","J34.89","H92.03","M25.452","M00.9","S79.912A","S71.002A","A41.9","M00.052","M86.9","F32.9","F41.9","F12.90","K29.70","Z90.49","Z90.710","Z88.5","R60.0","F11.99","F43.10","L08.9","M79.605","R22.42","D64.9","Z48.1","R56.9","L03.115","R51.9","L98.9","R23.4","M79.89"],"date":["2020-08-11","2020-07-19","2020-07-19","2020-07-25","2020-07-27","2020-07-30","2020-08-11","2020-08-11","2020-05-19","2020-07-25","2020-07-21","2020-07-09","2021-04-09","2020-08-03","2020-03-31","2020-03-31","2020-07-07","2020-08-04","2020-07-09","2020-07-09","2020-07-29","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2020-07-29","2020-08-11","2020-08-11","2020-08-11","2021-02-02","2021-04-09","2021-02-02","2021-02-02","2021-02-02","2021-02-02","2021-02-02","2020-07-07","2020-07-07","2020-07-25","2020-07-25","2020-07-25","2020-07-25","2020-07-25","2020-07-25","2020-07-25","2021-05-26","2021-05-26","2021-05-26","2020-03-27","2020-03-30","2020-07-21","2020-08-03","2020-03-26","2020-03-27","2020-03-27","2020-03-27","2020-03-27","2020-03-27","2020-03-27","2020-03-27","2020-03-27","2020-03-27","2020-06-12","2020-07-24","2020-07-24","2020-07-30","2020-06-12","2020-06-12","2020-07-21","2020-07-30","2021-03-17","2021-03-17","2021-03-17","2021-03-17","2021-03-17","2021-04-09"],"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":[["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","16714008210","HYDROXYZ","TAB 25MG","30","Select","Select",""],["","65162063609","PANTOPRAZOLE","TAB 20MG","30","Select","Select",""],["","31722053705","LEVETIRACETA","TAB 500MG","30","Select","Select",""],["","00054429931","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","14","Select","Select",""],["","65862042001","SMZ\/TMP","TAB 800-160","60","Select","Select",""],["","69543038810","KETOROLAC","TAB 10MG","15","Select","Select",""],["","67877041920","LINEZOLID","TAB 600MG","12","Select","Select",""],["","00228315303","BUPRENORPHIN","SUB 8MG","60","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":""}]}]}