{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LUCY  A COOK","gend":1,"add":"19642 HIGHWAY ONE LOT 3","city":"BRODNAX","state":"VA","zip":"23920-9998","dob":"1958-05-03","age":"","mstatus":"","insh":"20025736*01","cliId":"","pno":4347748225,"cno":4347748225,"email":"","ename":"","eno":"","pphy":"POWERS, LINDA P MD","ppno":4345842025,"pcpadd":"514 W ATLANTIC ST,","pcpcity":"SOUTH HILL","pcpstate":"VA","pcpzip":"23970-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4344472240,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M05.9","M35.00","Z79.899","I26.92","R07.9","R00.0","R53.1","I26.99","R57.8","N17.9","R06.02","G83.10","E11.9","I10.","F41.1","G40.909","G43.709","Z86.73","Z86.711","Z79.84","G45.9","Z74.09","I80.02","E11.42","E78.5","G43.909","K21.9","J45.909","E53.8","R79.89","Z20.822","Z79.82","Z79.01","Z79.51","Z90.49","J45.20","R94.31","M06.9","M54.12","M79.671","M54.9","M54.2","R29.818","Z90.89","Z98.890","Z90.710","M47.22","M79.643","I51.7","NO DATA","I36.1","Z12.11","Z23.","I21.4","R29.898","Z04.9","I26.02","I67.82","I63.233","I82.432","I12.9","E11.22","E87.6","Z82.3","R07.89","M06.4","M62.81","R09.89","I82.812","I35.8","M79.605"],"date":["2022-03-09","2022-03-09","2022-01-27","2023-06-21","2022-04-01","2022-04-01","2022-04-01","2023-06-21","2022-04-03","2022-04-03","2022-04-06","2022-04-19","2023-04-04","2023-04-04","2023-04-04","2022-08-24","2022-08-24","2022-08-24","2022-08-24","2022-08-24","2022-03-03","2022-01-27","2022-02-20","2022-03-03","2023-04-04","2022-02-20","2023-04-04","2023-04-04","2022-02-20","2022-02-20","2022-04-01","2022-03-03","2022-02-20","2022-02-20","2022-02-20","2022-03-03","2022-08-24","2021-02-01","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2022-01-27","2022-01-27","2022-01-27","2022-04-01","2022-03-09","2022-03-09","2022-08-24","2022-04-03","2022-04-03","2023-04-04","2021-06-10","2022-04-01","2022-01-27","2022-01-27","2022-04-01","2022-01-28","2022-01-28","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2021-03-19","2022-02-03","2022-02-18","2022-02-19","2022-01-28","2022-02-18"],"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":[["","45802065087","LORATADINE","10 MG","30","Select","Select",""],["","70010006310","METFORMIN","TAB 500MG","60","Select","Select",""],["","69097015915","MELOXICAM","TAB 15MG","30","Select","Select",""],["","00832105410","BACLOFEN","TAB 10MG","21","Select","Select",""],["","53191036201","VITAMIN D3","CAP 50000UNT","4","Select","Select",""],["","53885024450","ONETOUCH","TES ULTRA","50","Select","Select",""],["","65162062711","TRAMADOL HCL","50 MG","60","Select","Select",""],["","68180098103","LISINOPRIL","20 MG","30","Select","Select",""],["","10006073043","VITAMIN B-12","TAB 1000MCG","30","Select","Select",""],["","68382013805","TOPIRAMATE","TAB 25MG","60","Select","Select",""],["","70954006020","PREDNISONE","20 MG","10","Select","Select",""],["","57237016199","OMEPRAZOLE","20 MG","30","Select","Select",""],["","00173071920","FLOVENT HFA","AER 110MCG","12","Select","Select",""],["","67877051310","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","76385012350","METHOCARBAM","TAB 500MG","21","Select","Select",""],["","59310057922","PROAIR HFA","AER ","17","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","17","Select","Select",""],["","16729048601","METHOTREXATE","TAB 2.5MG","32","Select","Select",""],["","11534016503","FOLIC ACID","1 MG","30","Select","Select",""],["","69097022316","ALENDRONATE","TAB 35MG","4","Select","Select",""],["","65862001305","SERTRALINE","TAB 100MG","30","Select","Select",""],["","07610022640","MELATONIN","3 MG","30","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","00597015230","JARDIANCE","10 MG","30","Select","Select",""],["","31722053001","TORSEMIDE","10 MG","30","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","14","Select","Select",""],["","00069050130","XELJANZ XR","TAB 11MG","30","Select","Select",""],["","43386031208","GAVILAX","POW ","238","Select","Select",""],["","49483048112","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","59779030601","CVS PURELAX","POW ","476","Select","Select",""],["","50458057830","XARELTO","TAB 15MG","3","Select","Select",""],["","60758011910","PREDNISOLONE","SUS 1% OP","10","Select","Select",""],["","60505620201","CYCLOSPORINE","EMU 0.05% OP","60","Select","Select",""],["","00003089421","ELIQUIS","5 MG","60","Select","Select",""],["","59762500005","SULFASALAZIN","TAB 500MG","60","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","54838014440","CHLD SILAPAP","LIQ 160\/5ML","120","Select","Select",""],["","00023916360","RESTASIS","EMU 0.05% OP","60","Select","Select",""],["","59651038905","BUSPIRONE","TAB 5MG","60","Select","Select",""],["","00121086802","NYSTATIN","SUS 100000","200","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","21","Select","Select",""],["","66689003850","LACTULOSE","SOL 20GM\/30","90","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","15","Select","Select",""],["","65862086001","FAMOTIDINE","TAB 40MG","60","Select","Select",""],["","70010006310","METFORMIN HCL","500 MG","60","Select","Select",""],["","69097022316","ALENDRONATE SODIUM","35 MG","4","Select","Select",""],["","72205002405","ATORVASTATIN CALCIUM","40 MG","30","Select","Select",""],["","59651038905","BUSPIRONE HCL","5 MG","60","Select","Select",""],["","53885099425","ONETOUCH ULTRA TEST STRIP","","25","Select","Select",""],["","65862001305","SERTRALINE HCL","100 MG","30","Select","Select",""],["","45802091987","CETIRIZINE HCL","10 MG","30","Select","Select",""],["","00955100810","ENOXAPARIN SODIUM","80MG\/0.8ML","4.8","Select","Select",""],["","66993007996","FLUTICASONE PROPIONATE HFA","110 MCG","12","Select","Select",""],["","43386009019","GAVILYTE-G","236-22.74G","4000","Select","Select",""],["","00406012301","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","15","Select","Select",""],["","69097084507","CYCLOBENZAPRINE HCL","5 MG","30","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","70010075401","METHOCARBAMOL","500 MG","60","Select","Select",""],["","00093506005","HYDROXYZINE HCL","10 MG","30","Select","Select",""],["","53885024450","ONETOUCH TES ULTRA","","50","Select","Select",""],["","00597015230","JARDIANCE TAB","10MG","30","Select","Select",""],["","45802065087","LORATADINE TAB","10MG","30","Select","Select",""],["","31722053001","TORSEMIDE TAB","10MG","30","Select","Select",""],["","70010006310","METFORMIN TAB","500MG","60","Select","Select",""],["","07610022640","MELATONIN TAB","3MG","30","Select","Select",""],["","65862001305","SERTRALINE TAB","100MG","30","Select","Select",""],["","69097022316","ALENDRONATE TAB","35MG","4","Select","Select",""],["","68180098103","LISINOPRIL TAB","20MG","30","Select","Select",""],["","57237016199","OMEPRAZOLE CAP","20MG","30","Select","Select",""],["","68382077501","METHOTREXATE TAB","2.5MG","32","Select","Select",""],["","59779030601","CVS PURELAX POW","","476","Select","Select",""],["","49483048112","ASPIRIN LOW TAB","81MG EC","30","Select","Select",""],["","43386031208","GAVILAX POW","","238","Select","Select",""],["","54838014440","CHLD SILAPAP LIQ","160\/5ML","120","Select","Select",""],["","50458057830","XARELTO TAB","15MG","3","Select","Select",""],["","11534016503","FOLIC ACID TAB","1MG","30","Select","Select",""],["","72205002405","ATORVASTATIN TAB","40MG","30","Select","Select",""],["","00378064010","PREDNISONE TAB","5MG","50","Select","Select",""],["","60505620201","CYCLOSPORINE EMU","0.05% OP","60","Select","Select",""],["","00003089421","ELIQUIS TAB","5MG","60","Select","Select",""],["","00023916360","RESTASIS EMU","0.05% OP","60","Select","Select",""],["","59762500005","SULFASALAZIN TAB","500MG","60","Select","Select",""],["","53885004601","ONETOUCH KIT ULTRA","2","1","Select","Select",""],["","60758011910","PREDNISOLONE SUS","1% OP","10","Select","Select",""],["","00832105410","BACLOFEN TAB","10MG","21","Select","Select",""],["","68462010530","ONDANSETRON TAB","4MG","15","Select","Select",""],["","59651038905","BUSPIRONE TAB","5MG","60","Select","Select",""],["","66689003850","LACTULOSE SOL","20GM\/30","90","Select","Select",""],["","45802091987","CETIRIZINE TAB","10MG","30","Select","Select",""],["","65862086001","FAMOTIDINE TAB","40MG","60","Select","Select",""],["","50111033401","METRONIDAZOL TAB","500MG","21","Select","Select",""],["","00121086802","NYSTATIN SUS","100000","200","Select","Select",""],["","00078091112","XIIDRA","5 %","60","Select","Select",""],["","00603188016","LIDOCAINE","5 %","15","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":""}]}]}