{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PAIGE E CARROLL","gend":1,"add":"305 WALNUT ST APT 12","city":"APPALACHIA","state":"VA","zip":"24216-9998","dob":"1996-04-01","age":"","mstatus":"","insh":"1587578*01","cliId":"","pno":2762207748,"cno":2762207748,"email":"","ename":"","eno":"","pphy":"STALLARD, KAREN J NP","ppno":2765236715,"pcpadd":"323 CLOVERLEAF SQUARE # 1,","pcpcity":"BIG STONE GAP","pcpstate":"VA","pcpzip":"24219-9998","pcpcounty":"","pcpid":"","pcpname":"Bhma Laboratory Services Norton","plan":"OHP","program":"MEDICAID","lob":"M4","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2765236719,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O76.","O45.93","Z3A.38","Z37.0","O99.02","O99.334","F17.200","D64.9","Q21.0","Z98.890","R63.8","J38.01","Z93.1","F15.10","F32.9","Z86.59","Z30.019","O46.93","Z3A.00","F41.9","R03.0","R63.5","Z13.220","NO DATA","F15.20","F11.99","A59.00"],"date":["2021-01-07","2021-01-07","2021-01-07","2021-01-07","2021-01-07","2021-01-07","2021-01-07","2021-01-07","2021-02-11","2021-02-11","2021-02-11","2021-02-11","2021-02-11","2022-01-12","2022-01-12","2021-03-10","2021-03-10","2021-01-07","2021-01-07","2022-02-21","2022-02-21","2022-02-21","2022-02-21","2022-02-21","2021-09-23","2021-09-23","2023-06-12"],"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":[["","00406051201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","65162046935","ELURYNG","MIS ","1","Select","Select",""],["","70700016406","LEVONORGESTR","TAB 1.5MG","8","Select","Select",""],["","50261031301","ANNOVERA","MIS ","1","Select","Select",""],["","66993060536","ETONOGESTREL","MIS ETHY EST","1","Select","Select",""],["","65862001205","SERTRALINE","TAB 50MG","30","Select","Select",""],["","65162027250","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","00093506110","HYDROXYZ HCL","TAB 25MG","30","Select","Select",""],["","61783000012","FC2 FEMALE","MIS CONDOM","12","Select","Select",""],["","00378728053","NORETH\/ETHIN","TAB 43831","84","Select","Select",""],["","73302045601","ELLA","TAB 30MG","2","Select","Select",""],["","00093767902","ETONOGESTREL-ETHINYL ESTRADIOL .","12-.015MG","1","Select","Select",""],["","69452029020","ACYCLOVIR","400 MG","21","Select","Select",""],["","66993060536","ETONOGESTREL MIS ETHY EST","","1","Select","Select",""],["","65862001205","SERTRALINE TAB","50MG","30","Select","Select",""],["","00093506110","HYDROXYZ HCL TAB","25MG","30","Select","Select",""],["","65162027250","SMZ\/TMP DS TAB","800-160","20","Select","Select",""],["","61783000012","FC","2 FEMALE MIS CONDOM","12","Select","Select",""],["","50261031301","ANNOVERA MIS","","1","Select","Select",""],["","73302045601","ELLA TAB","30MG","2","Select","Select",""],["","00378728053","NORETH\/ETHIN TAB","1\/20","84","Select","Select",""],["","51862014803","HALOETTE .","12-.015MG","1","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":""}]}]}