{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CARLA   H DEACON","gend":1,"add":"119 PARSONS ROAD","city":"TROUTVILLE","state":"VA","zip":"24175-9998","dob":"1989-12-23","age":"","mstatus":"","insh":"2234535*01","cliId":"","pno":"540\/581-2944","cno":"540\/581-2944","email":"","ename":"","eno":"","pphy":"RAZA, QUASIR MD","ppno":"540\/283-3660","pcpadd":"6136 PETERS CREEK ROAD","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":24019,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/283-3677","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S52.572A","S52.615A","L40.9","W19.XXXA","M79.603","M66.242","M65.842","N39.0","R30.0","R35.0","S69.91XA","W22.8XXA","S20.319A","S00.81XA","S61.452A","S61.551A","F17.290","Z56.0","R20.0","S41.102A","M25.532","W55.01XA","W55.03XA","S01.81XA","T14.8XXA","S62.306A","W18.39XA","N30.00","Z32.02","F50.2","V54.12","W19.XXXD","S52.502A","Z48.89","S06.0X1A","M54.2","R07.81","S00.03XA","F17.200","Z53.29","Z79.899","R55.","S06.0X0A","W10.9XXA","R10.11","R10.31","R11.2","S61.451A","F31.9","F60.3","M65.9","Z86.59","Z90.49","Z88.1","Z88.5","R50.9","R05.","Z71.89","F33.1","NO DATA","Z91.14","S30.1XXA","V29.9XXA","F41.8","S68.711A","F41.9","S60.221A","R51.","V49.50XA","S66.802A","R10.9","R63.0","R11.0","S62.326A","G89.18","Z23.","F32.2","Z76.89","F31.75","Z32.00","K21.9","M53.3","R10.32","N93.0","L73.2","N76.0","B96.89","M79.641","S41.112A","F10.129","F14.90","S51.812A","F19.10","Z20.828","S00.83XA","W01.198A","S52.515A","V62.84","R51.9","L90.5","Z09.","M79.642","G90.511","X78.8XXA","S66.212A","X58.XXXA","Z87.891"],"date":["2021-08-12","2021-08-27","2021-08-25","2021-08-12","2021-08-12","2021-10-08","2021-10-08","2022-04-21","2022-04-21","2022-04-21","2022-09-18","2022-08-31","2022-08-06","2022-08-06","2022-08-07","2022-08-06","2022-09-18","2022-09-18","2022-08-07","2022-08-06","2022-08-06","2022-08-07","2022-08-07","2022-08-07","2022-08-07","2020-10-28","2021-08-03","2020-10-12","2020-10-12","2020-10-12","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-11-11","2021-11-11","2021-11-11","2021-11-11","2021-11-11","2021-11-11","2021-11-11","2021-11-11","2021-11-11","2021-02-24","2022-07-13","2022-07-13","2022-07-13","2022-08-07","2022-08-07","2022-08-07","2022-08-07","2022-08-07","2022-08-07","2022-08-07","2022-08-07","2020-03-24","2020-03-24","2020-03-24","2020-12-20","2020-12-20","2020-12-20","2021-04-26","2021-04-26","2021-10-08","2022-08-31","2020-12-19","2022-08-31","2020-08-21","2020-08-21","2021-10-08","2022-07-13","2022-07-13","2022-07-13","2020-08-10","2020-07-13","2020-08-17","2020-12-22","2021-02-15","2021-02-15","2021-02-15","2021-02-15","2021-04-14","2021-04-14","2020-01-24","2020-01-24","2020-01-24","2020-01-24","2020-07-09","2020-12-19","2021-10-24","2020-12-19","2020-12-19","2020-12-19","2020-12-19","2021-02-21","2021-02-21","2021-08-03","2021-10-24","2022-05-20","2020-07-13","2020-07-27","2020-07-27","2020-08-10","2020-12-19","2021-10-08","2021-10-08","2021-10-08"],"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":[["","62332054730","CLOBETASOL","CRE 0.0005","30","Select","Select",""],["","13811071910","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","14","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","59676058015","JANSSEN","INJ COVID-19","0","Select","Select",""],["","65862022701","LAMOTRIGINE","TAB 25MG","120","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","30","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","20","Select","Select",""],["","60505025203","TIZANIDINE","TAB 4MG","30","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","14","Select","Select",""],["","59762444002","METHYLPRED","TAB 4MG","21","Select","Select",""],["","14539067401","HYDROXYZ","CAP 25MG","240","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","00781707787","METRONIDAZOL","GEL 0.75%VAG","70","Select","Select",""],["","68382024701","BENZONATATE","CAP 100MG","30","Select","Select",""],["","65862017601","PENICILLN","TAB 500MG","30","Select","Select",""],["","45802008801","ALBUTEROL","AER HFA","8","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","12","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","69097084615","CYCLOBENZAPR","TAB 10MG","21","Select","Select",""],["","00536440901","VITAMIN","TAB 100MG","60","Select","Select",""],["","50428043019","CVS","TAB 100MG","60","Select","Select",""],["","35046000124","B-6","TAB 250MG","90","Select","Select",""],["","70710122501","AMITRIPTYLIN","TAB 10MG","30","Select","Select",""],["","58160082652","HAVRIX","INJ 1440UNIT","1","Select","Select",""],["","58160081552","TWINRIX","INJ ","1","Select","Select",""],["","69097081312","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","58160082152","ENGERIX-B","INJ 20MCG\/ML","1","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":""}]}]}