{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SUSIE A STEPHENS","gend":1,"add":"739 BRICKYARD ROAD","city":"EMPORIA","state":"VA","zip":"23847-9998","dob":"1961-04-12","age":"","mstatus":"","insh":"20007592*01","cliId":"","pno":4343785514,"cno":4343785514,"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":"OHCC","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":["R60.9","R06.02","I08.3","I50.23","R79.89","Z20.822","R59.0","Z72.0","Z95.810","I25.5","J44.1","K21.9","R07.89","I11.0","I50.9","I50.22","I42.9","F17.210","N39.0","I25.10","M06.9","I25.2","Z79.82","Z79.51","Z79.899","Z95.5","Z28.09","R06.00","J44.9","I51.9","F12.10","I10.","L29.9","T78.1XXA","F41.9","Z71.6","R63.4","I42.8","F17.200","R53.83","F14.90","E78.5","R94.31","I50.21"],"date":["2022-02-08","2022-02-08","2022-02-08","2023-07-30","2022-02-11","2023-07-21","2022-02-11","2022-02-11","2022-02-11","2022-10-29","2022-02-11","2022-02-11","2022-10-29","2023-07-21","2023-07-21","2022-04-11","2023-09-06","2022-09-29","2023-07-30","2023-09-06","2022-02-08","2022-02-07","2022-02-07","2022-02-07","2022-02-07","2023-07-28","2022-02-07","2022-02-09","2023-07-30","2022-02-07","2022-02-08","2023-09-06","2022-07-11","2022-07-11","2022-09-29","2022-09-29","2022-09-29","2023-07-21","2023-07-30","2023-07-21","2023-07-30","2023-09-06","2023-09-06","2023-07-28"],"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":[["","00228202950","ALPRAZOLAM","TAB 0.5MG","60","Select","Select",""],["","16729022501","SPIRONOLACT","TAB 25MG","90","Select","Select",""],["","49348098023","SM ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","10006073038","MAG OXIDE","TAB 400MG","30","Select","Select",""],["","49035056314","ASPIRIN LOW","TAB 81MG EC","90","Select","Select",""],["","68382009305","CARVEDILOL","6.25 MG","60","Select","Select",""],["","68645059459","FAMOTIDINE","20 MG","180","Select","Select",""],["","68645055354","LISINOPRIL","20 MG","30","Select","Select",""],["","00143177201","ISOSORB DIN","TAB 20MG","60","Select","Select",""],["","65862053650","LEVOFLOXACIN","TAB 250MG","7","Select","Select",""],["","65162068210","PHENAZOPYRID","TAB 200MG","6","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00054001825","PREDNISONE","TAB 20MG","4","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","43547040111","FUROSEMIDE","20 MG","30","Select","Select",""],["","63304061650","DOXYCYC MONO","CAP 100MG","9","Select","Select",""],["","00832532511","POT CL MICRO","TAB 20MEQ ER","60","Select","Select",""],["","72888008301","ISOSORBIDE DINITRATE","20 MG","60","Select","Select",""],["","53746051101","SPIRONOLACTONE","25 MG","90","Select","Select",""],["","00143177201","ISOSORB DIN TAB","20MG","60","Select","Select",""],["","68382009305","CARVEDILOL TAB","6.25MG","60","Select","Select",""],["","68645055354","LISINOPRIL TAB","20MG","30","Select","Select",""],["","68645059459","FAMOTIDINE TAB","20MG","60","Select","Select",""],["","16729022501","SPIRONOLACT TAB","25MG","30","Select","Select",""],["","60258017101","MAG OXIDE TAB","400MG","30","Select","Select",""],["","00310737020","BUDES\/FORMOT AER","160-4.5","10","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","00186037020","SYMBICORT AER","160-4.5","10","Select","Select",""],["","68180096301","ALBUTEROL AER HFA","","8","Select","Select",""],["","00228202910","ALPRAZOLAM TAB","0.5MG","60","Select","Select",""],["","43547040111","FUROSEMIDE TAB","20MG","30","Select","Select",""],["","63304061650","DOXYCYC MONO CAP","100MG","9","Select","Select",""],["","00054001825","PREDNISONE TAB","20MG","4","Select","Select",""],["","00832532511","POT CL MICRO TAB","20MEQ ER","60","Select","Select",""],["","51672131001","BETAMETHASONE DIPROP AUGMENTED","0.05 %","45","Select","Select",""],["","60258017101","MAGNESIUM OXIDE","400 MG","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":""}]}]}