{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANTHONY RING","gend":0,"add":"9632 SUNSET DR","city":"WISE","state":"VA","zip":"24293-9998","dob":"1980-06-18","age":"","mstatus":"","insh":"2283850*01","cliId":"","pno":"276\/639-9184","cno":"276\/639-9184","email":"","ename":"","eno":"","pphy":"RATLIFF, CHRISTOPHER J NP","ppno":"276\/455-5556","pcpadd":"208 FRONT ST W","pcpcity":"COEBURN","pcpstate":"VA","pcpzip":24230,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F32.1","R06.02","G56.03","G72.9","E04.1","E05.90","K21.9","Z79.899","D48.5","E11.9","R45.0","R94.2","L98.9","F17.200","F41.9","Z00.01","R55.","R51.9","I25.10","I11.0","I50.9","E78.5","E78.2","F17.210","F31.9","G47.33","I25.2","Z82.49","Z79.82","Z79.02","E55.9","R20.2","E53.8","Z23.","Z20.6","F32.9","J06.9","Z20.822","Z72.0","M25.50","R53.81","R53.83","I10.","R73.03","F51.01","R73.09","R53.1","S06.9X0A","F07.81","V57.5XXA"],"date":["2020-10-05","2020-08-27","2021-08-11","2020-10-14","2022-06-14","2022-06-14","2022-06-14","2020-09-08","2021-11-03","2022-05-19","2022-05-19","2020-09-03","2021-09-24","2021-09-24","2022-05-17","2021-05-17","2021-08-11","2021-08-11","2021-08-11","2021-08-11","2021-08-11","2021-08-11","2022-05-17","2021-08-11","2022-05-17","2021-08-11","2022-05-17","2021-08-11","2021-08-11","2021-08-11","2020-04-09","2020-08-19","2020-04-09","2021-04-17","2021-09-24","2021-01-14","2021-08-07","2021-08-07","2021-08-07","2020-08-19","2020-08-19","2020-08-19","2022-05-17","2022-05-17","2020-08-14","2020-08-14","2020-09-14","2021-08-11","2021-08-11","2021-08-11"],"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":[["","68645059090","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","68645059459","FAMOTIDINE","TAB 20MG","90","Select","Select",""],["","72205000490","ROSUVASTATIN","TAB 20MG","30","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","14","Select","Select",""],["","65862055990","PANTOPRAZOLE","TAB 20MG","30","Select","Select",""],["","13668022030","ARIPIPRAZOLE","TAB 20MG","30","Select","Select",""],["","31722070290","LOSARTAN","TAB 100MG","30","Select","Select",""],["","68645052354","SERTRALINE","TAB 100MG","30","Select","Select",""],["","50742061710","METOPROL","TAB 100MG ER","30","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","30","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","50","Select","Select",""],["","23155007001","METHIMAZOLE","TAB 5MG","15","Select","Select",""],["","58160082652","HAVRIX","INJ 1440UNIT","1","Select","Select",""],["","58160084252","BOOSTRIX","INJ ","0","Select","Select",""],["","68645058259","METFORMIN","TAB 500MG","60","Select","Select",""],["","00005200010","PREVNAR","INJ ","0","Select","Select",""],["","65862062405","GEMFIBROZIL","TAB 600MG","180","Select","Select",""],["","49035019402","EQ","DIS 21MG\/24H","28","Select","Select",""],["","31722070930","SILDENAFIL","TAB 25MG","30","Select","Select",""],["","70710136703","EMTR\/TENOFOV","TAB 200-300","30","Select","Select",""],["","50111078710","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","29033000305","SUCRALFATE","TAB 1GM","60","Select","Select",""],["","65862069730","VENLAFAXINE","CAP 150MG ER","30","Select","Select",""],["","13668033301","TRAZODONE","TAB 300MG","30","Select","Select",""],["","00536589453","NICOTINE","DIS 7MG\/24HR","28","Select","Select",""],["","00185061501","HYDROXYZ","CAP 50MG","90","Select","Select",""],["","69315090401","LORAZEPAM","TAB 0.5MG","30","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","52937000120","VASCEPA","CAP 1GM","120","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":""}]}]}