{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TI'ERRA   N VAUGHAN","gend":1,"add":"406 HIGH ST APT D","city":"EMPORIA","state":"VA","zip":"23847-9998","dob":"1995-03-09","age":"","mstatus":"","insh":"5091292*01","cliId":"","pno":"434\/430-0323","cno":"","email":"","ename":"","eno":"","pphy":"ANDERSON, MICHAEL S MD","ppno":"434\/634-6101","pcpadd":"6 DOCTORS DRIVE","pcpcity":"EMPORIA","pcpstate":"VA","pcpzip":23847,"pcpcounty":"","pcpid":"","pcpname":"EMPORIA MEDICAL ASSOCIATES PC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/634-7107","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N93.8","N89.7","N92.0","N91.1","E28.2","Z13.220","R73.03","R10.31","S39.91XA","F33.2","D50.9","N92.1","Z97.5","O34.211","Z37.0","Z3A.39","Z30.017","Z33.1","Z79.899","F33.1","O34.219","O99.02","O26.892","R10.2","Z3A.19","O47.1","Z3A.38","Z32.02","Z30.46","N94.89","J06.9","D64.9","N92.6","J09.X2","J20.9","N93.9","Z87.59","O20.9","Z3A.00","N91.2","J45.909","D53.9","F33.0","R53.1"],"date":["2020-01-17","2020-01-17","2020-01-17","2020-01-17","2020-01-17","2020-01-17","2020-01-17","2020-09-04","2020-09-04","2020-12-29","2021-01-25","2021-07-29","2021-07-29","2021-01-25","2021-01-25","2021-01-25","2021-04-19","2020-09-04","2020-09-04","2020-12-08","2021-01-25","2021-01-25","2020-09-04","2020-09-04","2020-09-04","2021-01-16","2021-01-16","2021-04-19","2021-11-08","2021-04-19","2019-03-21","2019-09-17","2019-09-17","2019-02-06","2019-02-06","2019-08-02","2019-07-31","2019-07-31","2019-07-31","2019-07-11","2019-07-11","2019-07-31","2019-05-06","2019-08-02"],"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":[["","63304069301","CLINDAMYCIN","CAP 300MG","30","Select","Select",""],["","","SPRINTEC","TAB 28 DAY","","Select","Select",""],["","68462030929","NORGEST\/ETHI","TAB 0.25\/35","28","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","15","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","140","Select","Select",""],["","","LORYNA","TAB 3-0.02MG","","Select","Select",""],["","","KETOROLAC","TAB 10MG","","Select","Select",""],["","","SPIRONOLACT","TAB 100MG","","Select","Select",""],["","","CEFUROXIME","TAB 500MG","","Select","Select",""],["","76385012810","METFORMIN","TAB 500MG ER","30","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","","PRENATAL","TAB 27-0.8MG","","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","15","Select","Select",""],["","00004080085","TAMIFLU","CAP 75MG","10","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","60","Select","Select",""],["","60258019309","PRENATABS","TAB ","30","Select","Select",""],["","44946104501","PNV","TAB PLUS","30","Select","Select",""],["","00555077902","MEDROXYPR","TAB 10MG","10","Select","Select",""],["","68462039429","ALYACEN","TAB 12785","28","Select","Select",""],["","00054001829","PREDNISONE","TAB 20MG","10","Select","Select",""],["","70710101002","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","30","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","14","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":""}]}]}