{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANGELA M LANGHORNE","gend":1,"add":"587 HOLMAN MILL ROAD","city":"FARMVILLE","state":"VA","zip":"23901-9998","dob":"1970-07-27","age":"","mstatus":"","insh":"20030878*01","cliId":"","pno":4343903216,"cno":4343903216,"email":"","ename":"","eno":"","pphy":"BASHORE, RANDALL T MD","ppno":4345813271,"pcpadd":"RT 15 SOUTH,","pcpcity":"NEW CANTON","pcpstate":"VA","pcpzip":"23123-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4345811105,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.16","R26.89","M62.81","I42.0","E11.65","I10.","E78.2","F41.9","F17.200","R61.","M25.552","M54.31","Z23.","J02.0","NO DATA","Z20.822","R07.9","I11.0","J96.01","J18.9","I50.21","J96.02","I16.1","E87.2","I42.8","I16.0","E11.9","E66.01","Z68.31","F32.9","G89.29","M25.551","S92.514A","S92.214A","S93.491A","S86.311A","S86.111A","Z72.0","M79.671","F41.8","R73.03","R23.2","Z71.6","Z12.11","N76.1","I42.9"],"date":["2022-07-27","2022-07-27","2022-07-27","2022-06-23","2022-02-17","2022-02-17","2022-02-17","2022-02-17","2022-02-17","2022-02-17","2023-03-26","2021-10-07","2022-12-12","2023-03-26","2023-03-26","2023-03-26","2021-10-11","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2023-02-06","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2023-02-06","2023-02-06","2023-02-06","2023-02-06","2023-02-06","2023-02-06","2023-02-06","2021-02-26","2021-02-26","2021-02-26","2021-02-26","2021-02-26","2022-01-11","2022-01-11"],"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":[["","57237010099","METOPROL TAR","TAB 25MG","60","Select","Select",""],["","59762371901","ALPRAZOLAM","0.25 MG","30","Select","Select",""],["","45802065087","LORATADINE","10 MG","30","Select","Select",""],["","55111014512","FLUCONAZOLE","150 MG","3","Select","Select",""],["","57896091136","ASPIRIN","81 MG","30","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","64380074303","BUSPIRONE","TAB 15MG","60","Select","Select",""],["","69315011710","FUROSEMIDE","40 MG","90","Select","Select",""],["","64380086107","POT CHLORIDE","TAB 10MEQ ER","30","Select","Select",""],["","00781286810","OMEPRAZOLE","20 MG","30","Select","Select",""],["","00078065920","ENTRESTO","24 MG-26MG","60","Select","Select",""],["","65862019401","FLUOXETINE","CAP 40MG","90","Select","Select",""],["","16729001016","PRAVASTATIN","TAB 40MG","30","Select","Select",""],["","68462019005","NAPROXEN","500 MG","60","Select","Select",""],["","50111032703","HYDRALAZINE","TAB 25MG","90","Select","Select",""],["","51224000760","METFORMIN","TAB 500MG ER","60","Select","Select",""],["","69097015915","MELOXICAM","TAB 15MG","30","Select","Select",""],["","68382009706","PAROXETINE","TAB 10MG","30","Select","Select",""],["","00904759080","FEROSUL","325(65) MG","60","Select","Select",""],["","43547028950","BUPROPION","TAB 150MG SR","60","Select","Select",""],["","00555088602","ESTRADIOL","1 MG","30","Select","Select",""],["","50228018105","GABAPENTIN","400 MG","30","Select","Select",""],["","43598044874","NICOTINE TD","DIS 21MG\/24H","28","Select","Select",""],["","45802095702","NICOTINE","LOZ 4MG MINT","567","Select","Select",""],["","00904673080","ACETAMIN","TAB 500MG","20","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","50111033401","METRONIDAZOLE","500 MG","14","Select","Select",""],["","68462019705","PRAVASTATIN SODIUM","40 MG","30","Select","Select",""],["","64380074303","BUSPIRONE HCL","15 MG","60","Select","Select",""],["","64380086107","POTASSIUM CHLORIDE","10 MEQ","30","Select","Select",""],["","62756014202","METFORMIN HCL ER","500 MG","180","Select","Select",""],["","65862019401","FLUOXETINE HCL","40 MG","90","Select","Select",""],["","00093005805","TRAMADOL HCL","50 MG","56","Select","Select",""],["","69097084615","CYCLOBENZAPRINE HCL","10 MG","20","Select","Select",""],["","57237010099","METOPROLOL TARTRATE","25 MG","60","Select","Select",""],["","00536303006","NICOTINE GUM","4 MG","100","Select","Select",""],["","51660033301","ARTHRITIS PAIN RELIEF","650 MG","180","Select","Select",""],["","00781506120","AMOXICILLIN","875 MG","20","Select","Select",""],["","00904731460","ACETAMINOPHEN ER","650 MG","180","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":""}]}]}