{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AARIKA N GILLIS","gend":1,"add":"305 CHERRY ROCK RD APT G","city":"EMPORIA","state":"VA","zip":"23847-9998","dob":"1989-07-14","age":"","mstatus":"","insh":"1558911*01","cliId":"","pno":8043509715,"cno":8043509715,"email":"","ename":"","eno":"","pphy":"ANDERSON, MICHAEL S MD","ppno":4346346101,"pcpadd":"6 DOCTORS DRIVE,","pcpcity":"EMPORIA","pcpstate":"VA","pcpzip":"23847-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4346347107,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F30.2","G93.40","F29.","R45.6","R45.1","R41.0","Z20.828","Z78.1","R00.0","E86.0","F20.9","F43.20","F23.","NO DATA","R60.9","F25.0","F31.5","V62.84","V62.85","G47.00","R45.851","E78.00","R73.03","G25.79","F31.9","E87.6","F31.10","R94.31","Z51.81","F41.9","F39.","K21.9","R07.9","F30.8"],"date":["2021-03-22","2021-03-22","2021-04-12","2021-03-22","2021-03-22","2021-03-22","2021-03-22","2021-03-22","2021-04-05","2021-04-05","2021-05-03","2021-08-16","2021-03-23","2021-03-30","2021-04-05","2022-12-06","2021-06-30","2021-06-23","2021-06-23","2021-06-24","2021-06-24","2022-08-11","2022-08-11","2021-04-27","2021-06-25","2021-03-22","2021-03-22","2022-03-27","2021-04-14","2021-04-13","2021-05-03","2022-03-27","2022-03-27","2021-04-12"],"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":[["","65862049301","QUETIAPINE","TAB 200MG","90","Select","Select",""],["","65862059501","DIVALPROEX","TAB 500MG ER","180","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","90","Select","Select",""],["","00555030202","HYDROXYZ PAM","CAP 50MG","90","Select","Select",""],["","70000052102","OMEPRAZOLE","TAB 20MG DR","30","Select","Select",""],["","00121092716","PROMETHAZINE","SOL 6.25\/5ML","140","Select","Select",""],["","00093416173","AMOXICILLIN","SUS 400\/5ML","200","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","28","Select","Select",""],["","67877056110","METFORMIN","TAB 500MG","30","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","29300015001","QUETIAPINE FUMARATE","200 MG","90","Select","Select",""],["","65862059501","DIVALPROEX SODIUM ER","500 MG","180","Select","Select",""],["","69097083412","SERTRALINE HCL","50 MG","90","Select","Select",""],["","65862049301","QUETIAPINE TAB","200MG","90","Select","Select",""],["","65862059501","DIVALPROEX TAB","500MG ER","180","Select","Select",""],["","69097083412","SERTRALINE TAB","50MG","90","Select","Select",""],["","00115180401","HYDROXYZ PAM CAP","50MG","90","Select","Select",""],["","70000052102","OMEPRAZOLE TAB","20MG DR","30","Select","Select",""],["","00121092716","PROMETHAZINE SOL","6.25\/5ML","140","Select","Select",""],["","00093416173","AMOXICILLIN SUS","400\/5ML","200","Select","Select",""],["","59746000103","METHYLPRED TAB","4MG","21","Select","Select",""],["","65862085901","FAMOTIDINE TAB","20MG","28","Select","Select",""],["","00054327099","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","16571040250","CETIRIZINE TAB","10MG","30","Select","Select",""],["","67877056110","METFORMIN TAB","500MG","30","Select","Select",""],["","70377002911","ATORVASTATIN TAB","40MG","30","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":""}]}]}