{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PAULA  B KENNEDY","gend":1,"add":"691 PINECREST AVE APT A6","city":"BEDFORD","state":"VA","zip":"24523-9998","dob":"1961-03-07","age":"","mstatus":"","insh":"20030555*01","cliId":"","pno":8043891414,"cno":8043891414,"email":"","ename":"","eno":"","pphy":"STIRGWOLT, JENNIFER K DO","ppno":4342003366,"pcpadd":"800 5TH STREET","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":"24504-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4348472521,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","E78.5","Z79.899","Z72.0","F41.9","Z21.","R01.1","G40.909","G47.00","F32.9","Z63.9","Z60.3","Z65.8","F39.","R45.89","R56.9","G62.9","M81.0","K21.9","R60.9","M79.642","R52.","M25.561","M89.8X9","NO DATA","M79.671","R26.81","B20.","Z12.11","R25.1","J45.20","Z68.32","Z28.21","G89.29","R73.9"],"date":["2023-04-20","2022-12-21","2023-04-20","2022-12-21","2022-11-18","2022-04-11","2022-06-20","2022-06-20","2021-03-12","2021-03-12","2021-03-12","2021-03-12","2021-03-12","2021-03-12","2021-03-12","2021-04-27","2021-04-27","2023-04-20","2023-04-20","2022-12-21","2023-03-20","2021-03-09","2023-04-20","2023-03-13","2023-03-13","2023-03-13","2023-03-13","2023-04-20","2022-10-06","2022-11-18","2023-04-20","2022-11-18","2022-11-18","2023-04-20","2023-04-20"],"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":[["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","00245531790","KLOR-CON M10","TAB 10MEQ ER","14","Select","Select",""],["","49348098053","SM ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","00054429725","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","75834002012","VITAMIN D3","CAP 50000UNT","4","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","69097012805","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","16714003501","LEVETIRACETA","TAB 500MG","60","Select","Select",""],["","16714085301","METOPROL SUC","TAB 50MG ER","30","Select","Select",""],["","00093720198","PRAVASTATIN","TAB 20MG","30","Select","Select",""],["","51991070610","ALPRAZOLAM","TAB 1MG","90","Select","Select",""],["","27241009809","DULOXETINE","CAP 30MG","60","Select","Select",""],["","49702023113","TRIUMEQ","600-50-300","30","Select","Select",""],["","43598029390","PREGABALIN","CAP 75MG","60","Select","Select",""],["","00093083205","CLONAZEPAM","TAB 0.5MG","60","Select","Select",""],["","68382053701","POT CITRA ER","TAB 1080MG","30","Select","Select",""],["","62037071001","POT CL MICRO","TAB 10MEQ CR","30","Select","Select",""],["","53191036201","D3-50","CAP 50000UNT","4","Select","Select",""],["","16714063301","ALENDRONATE","TAB 70MG","4","Select","Select",""],["","00093005401","BUSPIRONE","TAB 10MG","60","Select","Select",""],["","65862020230","LOSARTAN POT","TAB 50MG","30","Select","Select",""],["","16714003501","LEVETIRACETAM","500 MG","60","Select","Select",""],["","65862020230","LOSARTAN POTASSIUM","50 MG","30","Select","Select",""],["","00093720198","PRAVASTATIN SODIUM","20 MG","30","Select","Select",""],["","64380074206","BUSPIRONE HCL","10 MG","60","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","16714085301","METOPROLOL SUCCINATE","50 MG","30","Select","Select",""],["","75834002012","VITAMIN D","3 1250 MCG","4","Select","Select",""],["","00378668910","PANTOPRAZOLE SODIUM","40 MG","30","Select","Select",""],["","53191036201","D3","50 1250 MCG","4","Select","Select",""],["","53191036201","D","3-50 1250 MCG","4","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":""}]}]}