{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BARBARA  M COLE","gend":1,"add":"483 DAVENPORT ROAD","city":"CUMBERLAND","state":"VA","zip":"23040-9998","dob":"1972-04-15","age":"","mstatus":"","insh":"20025553*01","cliId":"","pno":8048377713,"cno":8048377713,"email":"","ename":"","eno":"","pphy":"KSIONSKI, SEBASTIAN MD","ppno":4343155340,"pcpadd":"935 S MAIN ST","pcpcity":"FARMVILLE","pcpstate":"VA","pcpzip":"23901-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4342001679,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","G89.4","M54.16","M25.361","M19.031","M25.362","F31.2","M25.552","NO DATA","M46.1","Z72.0","G89.29","M79.7","M47.26","M25.561","M17.11","J44.1","I10.","R30.0","Z71.89","Z71.3","Z12.11","N30.90","Z11.3","Z01.419","R26.9","R06.2","F17.200","R10.9","Z11.59","M47.22","G56.01","M51.36","M53.3","M70.62","Z96.642","Z79.899","M54.2","M54.5","N39.3","J44.9","J40.","M17.0","M54.9","R32.","J18.9","F17.210","Z20.822","M62.81","G47.33"],"date":["2022-03-31","2022-03-31","2022-03-31","2021-10-21","2021-11-30","2021-10-21","2023-03-21","2023-02-08","2022-10-03","2022-10-03","2023-02-08","2023-02-08","2023-02-08","2022-01-27","2022-01-27","2022-03-16","2022-03-16","2022-03-16","2022-06-16","2022-06-16","2022-06-16","2022-06-16","2022-06-16","2022-06-16","2022-06-16","2022-07-02","2022-07-02","2022-07-02","2022-07-02","2023-02-27","2022-02-24","2021-07-22","2023-02-03","2023-02-03","2023-02-03","2023-02-03","2021-03-09","2021-08-19","2021-08-19","2023-03-27","2021-05-12","2023-02-27","2021-07-22","2022-07-01","2023-04-19","2023-03-21","2023-03-21","2023-03-21","2023-03-27","2023-04-21"],"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":[["","68462027030","ATOMOXETINE","CAP 80MG","30","Select","Select",""],["","65862014836","SUMATRIPTAN","TAB 100MG","9","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","61874013030","VRAYLAR","3 MG","30","Select","Select",""],["","70000043401","GAS RELIEF","80 MG","100","Select","Select",""],["","13668000701","ZOLPIDEM","TAB 5MG","30","Select","Select",""],["","55111018010","TIZANIDINE","TAB 4MG","60","Select","Select",""],["","68382014005","TOPIRAMATE","100 MG","60","Select","Select",""],["","13107003234","MIRTAZAPINE","45 MG","30","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","70000004701","ALL DAY ALLG","TAB 10MG","30","Select","Select",""],["","00781286810","OMEPRAZOLE","20 MG","60","Select","Select",""],["","65862000899","METFORMIN","TAB 500MG","120","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","68382018314","BUSPIRONE","TAB 30MG","30","Select","Select",""],["","65862022801","LAMOTRIGINE","100 MG","180","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","60","Select","Select",""],["","65862052305","GABAPENTIN","600 MG","90","Select","Select",""],["","23155050201","HYDROXYZ HCL","TAB 50MG","30","Select","Select",""],["","47469004837","MELATONIN TR","TAB 5-10MG","30","Select","Select",""],["","70000051102","NICOTINE TD","DIS 14MG\/24H","28","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","27241015604","OXYBUTYNIN","TAB 10MG ER","30","Select","Select",""],["","80777027310","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00904671772","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","47781035703","BUPREN\/NALOX","MIS 8-2MG","75","Select","Select",""],["","49281063515","FLUZONE QUAD","INJ 2021-22","0","Select","Select",""],["","59385002560","BELBUCA","MIS 600MCG","60","Select","Select",""],["","42192080101","PHENAZOPYRID","TAB 100MG","12","Select","Select",""],["","23155065201","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","47781030801","NITROFUR MAC","CAP 100MG","10","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","65862067805","ALPRAZOLAM","1 MG","90","Select","Select",""],["","49884015676","VARENICLINE","TAB 1MG","60","Select","Select",""],["","76385012450","METHOCARBAM","TAB 750MG","30","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","68180030360","CEFUROXIME","TAB 500MG","14","Select","Select",""],["","58160082311","SHINGRIX","50 MCG\/0.5","1","Select","Select",""],["","49281072210","FLUBLOK QUAD","INJ 2022-23","0","Select","Select",""],["","10702000601","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","43386035610","HYDROCO\/APAP","TAB 5-325MG","15","Select","Select",""],["","57237001899","DULOXETINE","CAP 30MG","30","Select","Select",""],["","61442010310","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","00904720660","SIMETHICONE","CHW 80MG","100","Select","Select",""],["","65162027250","SMZ\/TMP DS","TAB 800-160","14","Select","Select",""],["","00904506860","MI-ACID GAS","CHW 80MG","100","Select","Select",""],["","00781717612","NALOXONE","SPR 4MG","2","Select","Select",""],["","45802081184","NALOXONE HCL","SPR 4MG","2","Select","Select",""],["","57237001899","DULOXETINE HCL","30 MG","30","Select","Select",""],["","53746010905","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","15","Select","Select",""],["","50111078710","AZITHROMYCIN","250 MG","8","Select","Select",""],["","13668000701","ZOLPIDEM TARTRATE","5 MG","30","Select","Select",""],["","31722071930","ATOMOXETINE HCL","80 MG","30","Select","Select",""],["","64380078508","PREDNISONE","20 MG","8","Select","Select",""],["","27241015604","OXYBUTYNIN CHLORIDE ER","10 MG","60","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","00904671772","CETIRIZINE HCL","10 MG","30","Select","Select",""],["","51660093953","ALLERGY RELIEF","10 MG","30","Select","Select",""],["","68382018314","BUSPIRONE HCL","30 MG","30","Select","Select",""],["","57664050318","TIZANIDINE HCL","4 MG","60","Select","Select",""],["","61442010310","DICLOFENAC SODIUM","75 MG","60","Select","Select",""],["","00378827091","ALBUTEROL SULFATE","2.5 MG\/3ML","180","Select","Select",""],["","00069034530","PAXLOVID (EUA)","300-100 MG","30","Select","Select",""],["","00597007541","SPIRIVA HANDIHALER","18 MCG","30","Select","Select",""],["","70010075405","METHOCARBAMOL","500 MG","60","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":""}]}]}