{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARK J HARRIS","gend":0,"add":"415 MOORE STREET APT 1","city":"BRISTOL","state":"VA","zip":"24201-9998","dob":"1964-06-26","age":"","mstatus":"","insh":"20028749*01","cliId":"","pno":2764947622,"cno":2764947622,"email":"","ename":"","eno":"","pphy":"OBUEKWE, UZOMA N MD","ppno":2766444433,"pcpadd":"2001 EUCLID AVE,","pcpcity":"BRISTOL","pcpstate":"VA","pcpzip":"24201-9998","pcpcounty":"","pcpid":"","pcpname":"Grace Family Medicine Clinic","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2766444434,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R09.02","R07.2","Z72.0","H04.123","Z12.11","Z86.010","K82.8","K76.9","K42.9","E78.5","R07.9","G47.33","J44.9","I10.","K21.9","E66.9","J30.9","N52.9","M25.561","E55.9","R04.2","R74.01","R30.0","R03.0","I44.0","I49.8","K81.1","K76.0","R10.11","R79.89","R10.9","R11.0","R07.89","Z74.3","M51.16","Z23.","G47.30","F17.210","Z72.89","K74.60","Z82.49","R09.89","E87.5","M62.50","J01.90","M54.2","NO DATA","M54.16","Z87.891","R93.2","R61.","M51.36","D12.5","K57.30","R11.2","N50.812","Z00.00","F41.9","X50.1XXA"],"date":["2023-07-29","2022-03-06","2022-03-06","2023-09-15","2022-06-20","2022-07-12","2022-08-04","2022-08-04","2022-08-04","2023-01-26","2022-12-28","2023-01-26","2023-01-26","2023-05-08","2023-01-26","2023-01-26","2023-01-26","2023-01-26","2022-10-27","2023-01-26","2021-07-08","2022-01-24","2021-12-08","2022-03-06","2022-08-04","2022-08-04","2022-08-04","2022-08-04","2022-11-14","2022-04-21","2022-11-14","2022-11-14","2022-12-28","2022-12-28","2023-01-24","2022-10-27","2022-03-07","2022-03-07","2022-03-07","2022-03-07","2022-03-07","2022-03-07","2022-03-07","2022-03-07","2022-05-02","2023-08-21","2023-09-15","2023-08-22","2023-03-01","2022-04-11","2022-12-28","2023-01-26","2022-06-20","2022-06-20","2022-04-02","2022-04-02","2023-05-08","2023-05-08","2023-08-21"],"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":[["","29300012810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","16714089802","LORATADINE","TAB 10MG","30","Select","Select",""],["","70377000911","ROSUVASTATIN","TAB 40MG","30","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","90","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","30","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","68382050010","OMEPRAZOLE","40 MG","30","Select","Select",""],["","00536123441","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","80777027310","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","68180098101","LISINOPRIL","20 MG","30","Select","Select",""],["","79854004112","VITAMIN D3","TAB 2000UNIT","30","Select","Select",""],["","62135030920","CIPROFLOXACN","TAB 500MG","28","Select","Select",""],["","13668018830","SILDENAFIL","TAB 100MG","30","Select","Select",""],["","31604002674","D3","TAB 2000UNIT","30","Select","Select",""],["","00591079401","DICYCLOMINE","CAP 10MG","30","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","10","Select","Select",""],["","00781261301","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","00603533815","PREDNISONE","PAK 10MG","21","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","21","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","69230031701","ALLERGY RELF","TAB 10MG","30","Select","Select",""],["","69547035302","NARCAN","SPR 4MG","2","Select","Select",""],["","65162004710","OXYCODONE","TAB 5MG","18","Select","Select",""],["","51672300302","HYDROCORT","CRE 0.025","57","Select","Select",""],["","69097084607","CYCLOBENZAPR","TAB 10MG","21","Select","Select",""],["","68462017901","NAPROXEN SOD","TAB 550MG","60","Select","Select",""],["","43386048024","ORPHENADRINE","TAB 100MG ER","20","Select","Select",""],["","29300012810","HYDROCHLOROTHIAZIDE","25 MG","30","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","69230031701","ALLERGY RELIEF","10 MG","30","Select","Select",""],["","65862059801","TAMSULOSIN HCL","0.4 MG","30","Select","Select",""],["","65862018730","ONDANSETRON HCL","4 MG","30","Select","Select",""],["","51672300302","HYDROCORTISONE","2.5 %","28.35","Select","Select",""],["","55111018015","TIZANIDINE HCL","4 MG","90","Select","Select",""],["","31722071130","SILDENAFIL CITRATE","100 MG","30","Select","Select",""],["","70377000913","ROSUVASTATIN CALCIUM","40 MG","30","Select","Select",""],["","31604002674","VITAMIN D","3 50 MCG","30","Select","Select",""],["","23155002401","BUSPIRONE HCL","10 MG","60","Select","Select",""],["","13668018830","SILDENAFIL TAB","100MG","30","Select","Select",""],["","31604002674","D","3 TAB 2000UNIT","30","Select","Select",""],["","16729028715","ROSUVASTATIN TAB","40MG","30","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","68180098101","LISINOPRIL TAB","20MG","30","Select","Select",""],["","29300012810","HYDROCHLOROT TAB","25MG","30","Select","Select",""],["","68382050010","OMEPRAZOLE CAP","40MG","30","Select","Select",""],["","55111018015","TIZANIDINE TAB","4MG","90","Select","Select",""],["","00143312601","DICYCLOMINE CAP","10MG","30","Select","Select",""],["","57237007530","ONDANSETRON TAB","4MG","10","Select","Select",""],["","68180096301","ALBUTEROL AER HFA","","8","Select","Select",""],["","00781261301","AMOXICILLIN CAP","500MG","30","Select","Select",""],["","59746017506","PREDNISONE TAB","20MG","10","Select","Select",""],["","42806071401","BENZONATATE CAP","100MG","21","Select","Select",""],["","53746010901","HYDROCO\/APAP TAB","5-325MG","12","Select","Select",""],["","69230031701","ALLERGY RELF TAB","10MG","30","Select","Select",""],["","69547035302","NARCAN SPR","4MG","2","Select","Select",""],["","80777027310","MODERNA VAC INJ COVID-","19","0","Select","Select",""],["","65162004710","OXYCODONE TAB","5MG","18","Select","Select",""],["","51672300302","HYDROCORT CRE","2.5%","57","Select","Select",""],["","43386048024","ORPHENADRINE TAB","100MG ER","20","Select","Select",""],["","68462017901","NAPROXEN SOD TAB","550MG","60","Select","Select",""],["","69097084607","CYCLOBENZAPR TAB","10MG","21","Select","Select",""],["","00603533815","PREDNISONE PAK","10MG","21","Select","Select",""],["","00406012301","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","6","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":""}]}]}