{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KATIE   M SULLINS","gend":1,"add":"203 BURDOCK DR","city":"NICKELSVILLE","state":"VA","zip":"24271-9998","dob":"1998-02-18","age":"","mstatus":"","insh":"2192839*01","cliId":"","pno":"276\/225-9143","cno":"","email":"","ename":"","eno":"","pphy":"ARNETTE, BRYAN THOMAS MD","ppno":"276\/386-9771","pcpadd":"1754 US HWY 23 N","pcpcity":"WEBER CITY","pcpstate":"VA","pcpzip":24290,"pcpcounty":"","pcpid":"","pcpname":"HOLSTON MEDICAL GROUP PC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"276\/386-9387","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M26.629","O24.414","O99.213","E66.9","Z68.31","R53.81","O24.415","O99.210","R53.83","O99.345","D50.8","Z30.09","NO DATA","F32.1","F41.0","F43.10","T76.11XA","Z62.810","R00.0","R94.31","P83.81","Z98.890","Z78.9","O90.81","Z68.33","Z30.011","O24.419","O99.613","K80.20","O23.43","N39.0","O99.013","D64.9","O98.813","B37.9","O26.893","O75.9","O34.211","N85.8","O24.420","O99.892","N73.6","O99.344","R33.8","K21.9","F41.9","Z37.0","Z3A.39","Z34.83","Z23.","Z3A.29","H60.502","O24.425","O36.63X0","O33.9","O99.02","Z79.82","Z79.84","Z79.899","M65.4","R11.0","M54.89","O99.89","H92.02","F41.1","O26.899","R10.2","O36.8120","N89.8","R07.9","O26.613","K81.1","Z3A.31","O34.219","Z37.9","Z3A.00","J02.9","J06.9","O62.1","S50.862A","W57.XXXA","Z01.419","V23.9","V23.89","V23.87","F32.9","O26.811","V23.5","Z86.32","Z67.40","N83.11","Z3A.36","R11.2","R21.","O24.410","O34.83","Z68.35","H04.123","H10.45","R10.84","O60.03","O62.2","O36.60X0","R06.00","K80.21","R10.13","R10.31","K35.80","N91.2","Z32.01","I95.9","N76.0","O23.41","R10.32","Z3A.13","N92.6"],"date":["2020-01-23","2020-04-23","2020-04-23","2021-12-01","2020-04-23","2020-06-08","2020-06-08","2021-12-01","2020-06-08","2021-02-15","2020-08-06","2020-08-06","2021-12-01","2021-04-26","2021-04-26","2021-04-26","2021-04-26","2021-04-26","2021-10-10","2021-10-10","2020-05-11","2020-06-12","2021-05-06","2020-06-12","2020-06-12","2020-06-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-09-23","2020-02-17","2020-02-17","2020-04-28","2020-04-28","2020-04-28","2020-04-28","2020-04-28","2020-04-28","2020-04-28","2020-06-28","2021-10-12","2020-02-14","2020-02-17","2020-02-17","2021-02-15","2021-09-23","2021-09-23","2021-08-26","2021-08-26","2021-10-09","2021-10-10","2021-10-10","2021-10-12","2021-12-01","2021-12-01","2021-12-01","2020-01-02","2020-01-02","2020-04-29","2020-10-22","2020-10-22","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2020-04-09","2021-10-09","2020-10-22","2021-12-01","2021-12-01","2021-12-01","2021-02-24","2021-02-24","2020-04-03","2020-04-03","2020-04-29","2020-04-29","2021-10-09","2021-10-09","2019-05-03","2019-10-26","2019-05-03","2019-09-16","2019-09-16","2019-10-26","2019-10-25","2019-10-26","2019-10-26","2019-10-26","2019-07-16"],"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":[["","","ONETOUCH","TES VERIO","","Select","Select",""],["","00168034646","TERCONAZOLE","CRE 0.004","45","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","60","Select","Select",""],["","11917013481","LANCING","MIS DEVICE","1","Select","Select",""],["","65702073110","ACCU-CHECK","KIT GUIDE ME","1","Select","Select",""],["","","CEPHALEXIN"," CEPHALEXIN ","30","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","65862037401","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","68645013054","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","","ASPIRIN"," ASPIRIN ","30","Select","Select",""],["","65702071110","ACCU-CHEK","TES GUIDE","150","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","00115164501","NITROFUR","CAP 100MG","10","Select","Select",""],["","","FERROUS"," FERROUS ","30","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","14","Select","Select",""],["","","ONE"," ONE ","60","Select","Select",""],["","","SPRINTEC"," SPRINTEC ","28","Select","Select",""],["","","PRENAT"," PRENAT ","30","Select","Select",""],["","","ECOTRIN"," ECOTRIN ","30","Select","Select",""],["","","LANSOPRAZOLE","CAP 30MG DR","","Select","Select",""],["","","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","","LABETALOL","TAB 100MG","","Select","Select",""],["","","BALCOLTRA","TAB 0.1-20","","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","","SERTRALINE","TAB 50MG","","Select","Select",""],["","","CONTOUR","KIT NEXT EZ","","Select","Select",""],["","","TRUE","KIT AIR","","Select","Select",""],["","","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","","TRI-SPRINTEC","TAB ","","Select","Select",""],["","","NEO\/POLY\/HC","SUS 1% OTIC","","Select","Select",""],["","","METFORMIN","TAB 500MG ER","","Select","Select",""],["","","STOOL","CAP 100MG","","Select","Select",""],["","","PREDNISONE","TAB 10MG","","Select","Select",""],["","","HYDROXYZ","TAB 10MG","","Select","Select",""],["","","IRON","TAB 325MG","","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":""}]}]}