{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PATRICIA  A BLOOMER","gend":1,"add":"530 MILL CREEK ROAD","city":"FORT BLACKMORE","state":"VA","zip":"24250-9998","dob":"1963-10-09","age":"","mstatus":"","insh":"20024017*01","cliId":"","pno":2769403258,"cno":2769403258,"email":"","ename":"","eno":"","pphy":"ARNETTE, BRYAN THOMAS MD","ppno":2763869771,"pcpadd":"1754 US HWY 23 N","pcpcity":"WEBER CITY","pcpstate":"VA","pcpzip":"24290-9998","pcpcounty":"","pcpid":"","pcpname":"Holston Medical Group PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2763869387,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R21.","H40.1132","U07.1","Z20.828","R05.9","B37.0","M54.9","G89.29","Z79.899","D50.0","K92.2","D50.8","H40.1231","H40.1131","H25.13","J20.9","H66.90","H66.92","M19.90","M62.830","F33.9","K21.9","Z11.52","J40.","J42.","Z11.59","J02.9","J01.90","B37.2","I10.","Z78.0","G25.81","F41.9","R13.19","NO DATA","R11.2","F11.20","E55.9","R89.9","R68.89","D50.9","M25.562","E61.1","R13.14","Z23.","R60.9","N95.1","G47.00","R13.10","M25.50","M25.662","M23.92","M17.12","K57.30","N39.0","N76.0","B96.89","D64.9","R06.2","J30.9","S05.02XA","X58.XXXA","G47.33","R10.9","F13.20","H02.64","M23.307","E11.9","M23.204","R05.","E03.9"],"date":["2022-07-05","2021-02-03","2022-02-08","2022-02-08","2022-03-09","2022-02-08","2022-04-05","2022-04-05","2022-06-20","2023-04-20","2022-06-20","2023-04-10","2023-02-03","2021-08-06","2022-09-02","2022-03-09","2022-06-22","2021-02-08","2023-01-16","2023-04-12","2022-09-27","2023-01-16","2022-02-02","2022-02-02","2022-02-02","2022-06-22","2022-06-22","2022-06-22","2022-06-22","2023-04-12","2022-07-05","2023-04-12","2023-04-12","2022-07-05","2023-04-12","2023-04-12","2023-04-12","2023-04-12","2022-04-25","2022-04-25","2023-04-20","2022-10-21","2022-09-23","2022-09-23","2022-09-27","2023-01-16","2023-01-16","2022-09-27","2022-12-28","2022-06-20","2022-08-14","2022-10-21","2023-04-13","2022-11-30","2021-08-10","2021-07-01","2021-07-01","2022-03-09","2021-10-22","2021-10-22","2021-06-27","2021-06-27","2021-07-14","2022-01-18","2023-04-12","2022-03-25","2022-11-18","2023-04-12","2023-04-13","2021-02-08","2023-04-12"],"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":[["","69543025116","VIRTUSSIN AC","LIQ 100-10\/5","240","Select","Select",""],["","43547040710","CLONAZEPAM","1 MG","60","Select","Select",""],["","00172572960","FAMOTIDINE","40 MG","90","Select","Select",""],["","47781022905","OXYCOD\/APAP","TAB 7.5-325","30","Select","Select",""],["","57664050389","TIZANIDINE","TAB 4MG","60","Select","Select",""],["","65862056090","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00046110511","PREMPRO","0.3-1.5MG","28","Select","Select",""],["","57237000511","FLUCONAZOLE","150 MG","2","Select","Select",""],["","68382066001","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","00378292177","TELMISARTAN","TAB 40MG","90","Select","Select",""],["","23155050110","HYDROXYZ HCL","TAB 25MG","40","Select","Select",""],["","00781809003","AZITHROMYCIN","500 MG","5","Select","Select",""],["","68180097103","LEVOTHYROXIN","TAB 125MCG","90","Select","Select",""],["","68462019005","NAPROXEN","500 MG","60","Select","Select",""],["","64380073706","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","69097082412","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","80777027310","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","00023320503","LUMIGAN","SOL 0.0001","2","Select","Select",""],["","50111056103","TRAZODONE","TAB 100MG","30","Select","Select",""],["","61314054701","LATANOPROST","0.005 %","2.5","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","45802013970","METRONIDAZOL","GEL 0.75%VAG","70","Select","Select",""],["","00143980305","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","65862020299","LOSARTAN POT","TAB 50MG","30","Select","Select",""],["","58657050016","CODEINE\/GG","SOL 10-100\/5","240","Select","Select",""],["","33332032101","AFLURIA QUAD","INJ 2021-22","0","Select","Select",""],["","00173071920","FLOVENT HFA","AER 110MCG","12","Select","Select",""],["","69584061250","METHOCARBAM","TAB 750MG","90","Select","Select",""],["","42806071505","BENZONATATE","200 MG","60","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","47335070354","ALBUTEROL","NEB 0.00083","360","Select","Select",""],["","0","COMPOUND"," ","240","Select","Select",""],["","00006505506","MOLNUPIRAVIR","CAP 200MG","40","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","53746052110","PROMETHAZINE","TAB 25MG","15","Select","Select",""],["","45802005911","NYSTATIN","100000\/G","30","Select","Select",""],["","52747050230","FUSION PLUS","CAP ","30","Select","Select",""],["","27808006502","PROMETH\/COD","SOL 6.25-10","118","Select","Select",""],["","00173088710","TRELEGY","AER ELLIPTA","60","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","50111056103","TRAZODONE HCL","100 MG","30","Select","Select",""],["","68382066001","SPIRONOLACTONE","25 MG","30","Select","Select",""],["","69097082412","CITALOPRAM HBR","40 MG","30","Select","Select",""],["","65862020299","LOSARTAN POTASSIUM","50 MG","30","Select","Select",""],["","65862056090","PANTOPRAZOLE SODIUM","40 MG","30","Select","Select",""],["","57664050389","TIZANIDINE HCL","4 MG","60","Select","Select",""],["","47781022905","OXYCODONE-ACETAMINOPHEN","7.5-325 MG","30","Select","Select",""],["","68180097003","LEVOTHYROXINE SODIUM","112 MCG","90","Select","Select",""],["","69097052444","DICLOFENAC SODIUM","1 %","100","Select","Select",""],["","53746052110","PROMETHAZINE HCL","25 MG","15","Select","Select",""],["","70010077001","METHOCARBAMOL","750 MG","90","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":""}]}]}