{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KEIARA   L MARSHALL","gend":1,"add":"5072 GREEN CREEK ROAD","city":"SCHUYLER","state":"VA","zip":"22969-9998","dob":"2000-02-04","age":"","mstatus":"","insh":"9703330*01","cliId":"","pno":"434\/953-4829","cno":"434\/953-4829","email":"","ename":"","eno":"","pphy":"HEDIAN, KATHERINE DO","ppno":"434\/286-3602","pcpadd":"2256 IRISH ROAD","pcpcity":"ESMONT","pcpstate":"VA","pcpzip":22937,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/286-3819","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.9","O99.342","O99.612","K59.00","Z3A.23","O24.414","Z3A.37","O99.013","S93.402A","Z33.1","X50.1XXA","Y93.01","Y92.89","O99.343","V23.5","Z3A.34","Z34.83","Z3A.36","Z39.2","Z30.017","O26.892","M62.838","O99.810","Z3A.27","Z34.90","O99.019","O24.415","O24.410","D64.9","H53.10","Z34.82","Z86.32","R12.","Z3A.24","O28.3","N89.8","Z03.73","Z3A.28","Z23.","O35.8XX0","O99.345","NO DATA","O26.893","R10.9","O99.210","V23.7","Z3A.32","V23.89","Z28.3","Z03.74","O80.","Z3A.38","Z37.0","Z3A.33","O23.41","R23.3","Z3A.20","Z3A.30","O99.891","N94.89","W01.0XXA","N39.0","Z88.1","R10.32","Z34.81","Z3A.12","Z3A.31","O24.429","O69.89X0","O99.02","O24.439","R10.2","R30.0","Z3A.01","O09.32","O09.292","Z3A.17","O99.344","O99.52","J45.909","Z82.3","Z82.49","Z83.3","J02.9","Z20.828","J02.0","F32.9","F51.01","R11.0","O26.22","O99.89","Z3A.19","Z34.80","O24.419","G56.00","O47.9","Z01.818","D45.","O69.81X0","R09.81","R06.02","Z71.3","Z71.89","O99.341","Z3A.08","R52.","M54.89","R50.9","Z3A.35","O26.899","Z36.3"],"date":["2021-12-03","2021-06-21","2020-10-13","2020-10-13","2020-09-15","2020-12-22","2020-12-22","2021-09-23","2021-10-02","2021-10-02","2021-10-02","2021-10-02","2021-10-02","2021-10-07","2021-10-07","2021-10-07","2021-10-22","2021-10-22","2021-11-08","2021-11-08","2021-07-28","2020-10-13","2020-10-13","2020-10-13","2021-09-23","2020-12-01","2020-12-22","2020-12-01","2021-11-06","2021-06-10","2021-08-25","2021-11-06","2021-07-28","2021-07-28","2021-09-10","2021-10-02","2021-08-25","2021-08-25","2021-12-15","2021-09-10","2021-12-03","2021-12-03","2021-10-02","2021-10-02","2021-09-23","2021-09-23","2021-10-02","2021-09-23","2021-09-23","2021-09-23","2021-11-06","2021-11-06","2021-11-06","2020-11-24","2021-06-04","2021-06-04","2021-06-04","2021-09-10","2021-10-02","2021-10-02","2021-10-02","2022-05-25","2022-05-25","2022-05-25","2020-06-30","2020-06-30","2020-11-10","2020-12-29","2020-12-29","2021-11-06","2020-12-31","2021-03-26","2021-03-26","2021-03-26","2021-06-21","2021-06-21","2021-06-21","2021-11-06","2021-11-06","2021-11-06","2021-11-06","2021-11-06","2021-11-06","2022-01-24","2022-01-24","2022-01-24","2020-04-16","2020-04-16","2020-04-16","2020-08-18","2020-08-18","2020-08-18","2020-09-15","2020-11-17","2020-12-15","2020-12-15","2020-12-22","2020-12-22","2020-12-29","2020-03-05","2020-03-05","2020-03-05","2020-03-05","2020-06-04","2020-06-04","2020-08-17","2020-10-21","2020-02-28","2020-12-10","2020-12-10","2021-07-28"],"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":[["","13668001105","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","68001042300","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","00781261301","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","42571025201","CLINDAMYCIN","CAP 300MG","14","Select","Select",""],["","68462039610","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","68001036503","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","68001025320","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","49483034010","ACETAMIN","TAB 325MG","30","Select","Select",""],["","00093506110","HYDROXYZ","TAB 25MG","90","Select","Select",""],["","68382080510","TRAZODONE","TAB 50MG","60","Select","Select",""],["","69097083312","SERTRALINE","TAB 25MG","90","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","68001036103","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","68001024604","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","00378932132","WIXELA","AER 250\/50","60","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","10","Select","Select",""],["","53885059501","ONETOUCH","MIS 30G","100","Select","Select",""],["","23155010210","METFORMIN","TAB 500MG","180","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","180","Select","Select",""],["","08290328418","INSULIN","MIS 1ML\/31G","100","Select","Select",""],["","00169183411","NOVOLIN","INJ U-100","10","Select","Select",""],["","00002831501","HUMULIN","INJ U-100","10","Select","Select",""],["","69842087651","CVS","TAB 325MG","60","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","40","Select","Select",""],["","51552000405","POLY","GRA 8000","255","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":""}]}]}