{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LEWIS N COCHRAN","gend":0,"add":"8832 TROTTINRIDGE ROAD","city":"SKIPWITH","state":"VA","zip":"23968-9998","dob":"1960-09-17","age":"","mstatus":"","insh":"20025533*01","cliId":"","pno":4342654375,"cno":4342654375,"email":"","ename":"","eno":"","pphy":"HUFF, ASHLEIGH MARIE NP","ppno":4346962165,"pcpadd":"1508 K-V RD,","pcpcity":"VICTORIA","pcpstate":"VA","pcpzip":"23974-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4346961557,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F20.9","C61.","N13.8","M54.12","S16.1XXA","S39.012A","S20.20XA","V43.52XA","Y99.9","N40.1","Z85.46","R07.9","Z74.3","M50.23","G81.91","F12.99","M50.20","R53.1","F17.200","Z88.6","Z88.0","M54.6","M54.2","M79.601","M54.9","V89.2XXA","R06.02","R05.9","R91.1","R93.7","Z12.2","R91.8","R39.14"],"date":["2023-07-26","2023-07-17","2021-09-15","2022-05-11","2023-03-16","2023-03-16","2023-03-16","2023-03-16","2023-03-16","2023-07-17","2022-03-22","2023-03-16","2023-03-16","2022-03-22","2022-03-22","2022-03-22","2022-03-22","2022-03-22","2022-03-22","2022-03-22","2022-03-22","2022-03-22","2023-03-16","2023-03-14","2023-03-16","2023-03-14","2023-03-16","2023-03-16","2021-09-30","2021-09-30","2021-09-30","2021-09-30","2023-07-17"],"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":[["","60505311108","OLANZAPINE","5 MG","30","Select","Select",""],["","31604002517","CALCIUM\/VITD","TAB 500-400","60","Select","Select",""],["","55111025960","ZIPRASIDONE","CAP 80MG","60","Select","Select",""],["","65862014736","SUMATRIPTAN","TAB 50MG","30","Select","Select",""],["","57237001405","TAMSULOSIN","CAP 0.4MG","60","Select","Select",""],["","59762372001","ALPRAZOLAM","0.5 MG","90","Select","Select",""],["","23155050201","HYDROXYZ HCL","TAB 50MG","60","Select","Select",""],["","96295013570","CALCIUM\/D3","TAB ","60","Select","Select",""],["","80777027310","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","63304082990","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","59746017306","PREDNISONE","TAB 10MG","26","Select","Select",""],["","50228018010","GABAPENTIN","300 MG","90","Select","Select",""],["","00115180401","HYDROXYZ PAM","CAP 50MG","60","Select","Select",""],["","00536781708","OYSCO 500+D","TAB ","120","Select","Select",""],["","00406012305","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","6","Select","Select",""],["","00555030202","HYDROXYZINE PAMOATE","50 MG","60","Select","Select",""],["","55111025960","ZIPRASIDONE HCL","80 MG","60","Select","Select",""],["","52817033010","CYCLOBENZAPRINE HCL","5 MG","12","Select","Select",""],["","00378395205","ATORVASTATIN CALCIUM","40 MG","30","Select","Select",""],["","00591352530","LIDOCAINE","5 %","10","Select","Select",""],["","65862014736","SUMATRIPTAN SUCCINATE","50 MG","9","Select","Select",""],["","65862059805","TAMSULOSIN HCL","0.4 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":""}]}]}