{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHRISTOPHER RUTHERFORD","gend":0,"add":"631 HUME PL","city":"MARION","state":"VA","zip":"24354-9998","dob":"1985-07-08","age":"","mstatus":"","insh":"1581878*01","cliId":"","pno":2769443321,"cno":2769443321,"email":"","ename":"","eno":"","pphy":"TOWNSEND, CHARLOTTE ANN MD","ppno":2768893700,"pcpadd":"495 EAST MAIN ST,","pcpcity":"LEBANON","pcpstate":"VA","pcpzip":"24266-9998","pcpcounty":"","pcpid":"","pcpname":"Holston Medical Group PC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2768895505,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R05.","B34.9","I73.9","I10.","R74.8","I82.409","R09.02","I26.01","I25.119","K85.90","J12.89","A08.4","R52.","R11.2","R19.7","R22.41","F17.210","Z86.718","Z86.711","Z79.82","R29.898","U07.1","R11.0","Z72.0","I85.11","J96.00","I27.82","I16.0","I11.0","NO DATA","I25.10","I07.1","J45.909","K70.10","K74.60","K76.0","K80.20","D52.0","M79.671","K85.20","E87.6","E80.6","D72.821","R68.84","K04.7","I83.891","E83.42","E80.7","F10.10","D72.9","I36.1","M79.89","R10.13","Z20.822","S93.401A","S99.911A","D72.829","F19.10","E66.9","R71.8","Z87.09","I08.1","R07.9","R06.02"],"date":["2021-09-13","2021-09-13","2023-06-26","2022-08-22","2022-08-22","2021-12-20","2023-06-26","2023-06-26","2023-06-26","2023-06-26","2023-06-26","2021-01-21","2021-01-21","2021-01-21","2022-08-16","2021-03-15","2022-05-30","2022-08-23","2021-03-16","2021-03-16","2021-03-16","2022-08-26","2022-08-16","2021-03-16","2022-05-30","2022-08-26","2022-08-22","2022-08-26","2022-08-25","2022-08-26","2022-08-22","2022-08-26","2022-08-22","2022-08-26","2022-08-22","2022-08-22","2022-08-26","2022-08-22","2021-03-15","2022-08-26","2022-08-26","2022-08-24","2022-08-26","2021-09-16","2021-09-16","2022-05-30","2022-08-23","2022-08-23","2022-08-23","2022-08-25","2022-08-26","2021-10-12","2022-08-22","2022-08-22","2021-10-02","2021-10-02","2022-08-22","2022-08-22","2022-08-22","2022-08-22","2022-08-22","2022-08-23","2022-08-22","2022-08-22"],"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":[["","57237007530","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","00406012310","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","51224000160","BENZONATATE","CAP 200MG","20","Select","Select",""],["","59310058020","PROAIR RESPI","AER ","1","Select","Select",""],["","64980030310","CHLORTHALID","TAB 25MG","30","Select","Select",""],["","42571016242","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","65862016899","ATENOLOL","TAB 25MG","30","Select","Select",""],["","59746017210","PREDNISONE","TAB 5MG","21","Select","Select",""],["","00069034530","PAXLOVID","TAB 300-100","30","Select","Select",""],["","14613033972","QUICKVUE HOM","KIT COVID-19","2","Select","Select",""],["","00781717612","NALOXONE","SPR 4MG","2","Select","Select",""],["","58657050916","GUAIFENESIN","LIQ 100\/5ML","1200","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","8","Select","Select",""],["","68001016208","PROMETHAZINE","TAB 25MG","9","Select","Select",""],["","00143980305","DOXYCYCL HYC","CAP 100MG","14","Select","Select",""],["","59310058020","PROAIR RESPI AER","","1","Select","Select",""],["","65862016899","ATENOLOL TAB","25MG","30","Select","Select",""],["","00069034530","PAXLOVID TAB","300-100","30","Select","Select",""],["","82607066026","FLOWFLEX KIT TEST","","8","Select","Select",""],["","59746017210","PREDNISONE TAB","5MG","21","Select","Select",""],["","00781717612","NALOXONE SPR","4MG","2","Select","Select",""],["","58657050916","GUAIFENESIN LIQ","100\/5ML","1200","Select","Select",""],["","14613033972","QUICKVUE HOM KIT COVID-","19","8","Select","Select",""],["","68001016208","PROMETHAZINE TAB","25MG","9","Select","Select",""],["","57237007530","ONDANSETRON TAB","4MG","20","Select","Select",""],["","00143980305","DOXYCYCL HYC CAP","100MG","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":""}]}]}