{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"THERESA   M MILLER","gend":1,"add":"198 HAMILTON LN","city":"MAX MEADOWS","state":"VA","zip":"24360-9998","dob":"1964-11-04","age":"","mstatus":"","insh":"20032134*01","cliId":"","pno":2762364530,"cno":2762364530,"email":"","ename":"","eno":"","pphy":"RICHARDSON, HEATHER D NP","ppno":2767442224,"pcpadd":"279 GLADEVIEW DR","pcpcity":"FRIES","pcpstate":"VA","pcpzip":"24330-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":6672183826,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K31.9","K22.8","J44.9","R94.31","J44.1","J06.9","Z88.5","Z88.8","Z79.899","Z79.1","F41.9","F31.9","G89.29","K21.9","Z98.1","R09.89","R91.8","Z20.822","D72.829","E87.6","F17.210","R06.02","R07.9","K29.70","D64.9","J85.0","B96.89","J96.01","C34.90","T18.2XXA","J15.6","F22.","J44.0","G62.9","M41.9","R09.02","F43.10","E03.9","K52.9","J18.9","M50.30","M54.32","G43.909","G47.00","NO DATA","R10.84","Z86.010","R42.","R55.","A41.9","R32.","J96.10","R53.1","R53.83","M54.2","Z87.891","F32.9","J18.1","R68.83","R05.","R51.9","Z72.0","F41.8","M62.81","H10.45","Z20.5","R10.13","R11.0","R63.4","E53.9","J96.12","I08.3","R10.10","Z79.891","R50.9","K02.9","R04.2","J85.1","Z01.818","M54.6","M62.830","S80.01XA","S80.211A","W01.0XXA","Z87.01","Z85.118","J43.2","Z79.890","J96.11","R53.81","K59.00"],"date":["2021-02-17","2021-02-17","2023-02-12","2023-01-21","2022-12-26","2022-08-19","2023-01-21","2023-01-21","2023-01-21","2022-08-19","2023-01-22","2023-01-21","2022-08-19","2023-01-21","2023-01-21","2022-08-19","2023-01-24","2023-01-20","2022-12-26","2023-01-23","2023-01-24","2022-12-26","2022-12-26","2023-01-24","2023-01-24","2023-03-06","2023-03-06","2023-03-06","2023-03-06","2021-02-17","2021-05-10","2021-05-10","2021-05-10","2021-05-12","2021-05-10","2021-05-10","2023-01-21","2023-01-22","2021-05-11","2023-01-22","2022-10-28","2022-10-28","2022-10-28","2023-01-22","2022-10-28","2021-10-28","2022-10-28","2022-12-26","2022-12-26","2023-01-21","2023-01-22","2023-01-22","2021-05-10","2021-05-07","2021-05-07","2021-05-10","2021-05-10","2021-05-18","2021-05-10","2021-05-10","2021-05-10","2021-05-11","2021-05-11","2021-05-18","2022-04-06","2022-10-28","2021-03-30","2021-05-26","2021-03-30","2022-04-28","2022-12-12","2023-01-22","2021-05-26","2021-10-20","2021-10-20","2022-10-28","2022-11-27","2022-11-27","2021-02-12","2021-03-21","2021-03-21","2021-06-11","2021-06-11","2021-06-11","2022-11-27","2023-01-21","2023-01-21","2023-01-21","2023-01-21","2023-01-22","2023-01-22"],"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":[["","00781107905","ALPRAZOLAM","1 MG","90","Select","Select",""],["","13668000801","ZOLPIDEM","TAB 10MG","30","Select","Select",""],["","65862049101","QUETIAPINE","TAB 100MG","60","Select","Select",""],["","59651036205","IBUPROFEN","800 MG","90","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","68462039710","OMEPRAZOLE","40 MG","120","Select","Select",""],["","76204060030","IPRATROPIUM\/","SOL ALBUTER","540","Select","Select",""],["","64980033912","MAGNESIUM-OX","TAB 400MG","90","Select","Select",""],["","68462012705","GABAPENTIN","800 MG","135","Select","Select",""],["","69238183007","LEVOTHYROXIN","TAB 25MCG","90","Select","Select",""],["","27808003602","HYDROCO\/APAP","TAB 7.5-325","10","Select","Select",""],["","31722053301","METHOCARBAM","TAB 500MG","15","Select","Select",""],["","00603020922","MAG OXIDE","TAB 400MG","90","Select","Select",""],["","59762040101","SUCRALFATE","TAB 1GM","90","Select","Select",""],["","59762500801","MISOPROSTOL","TAB 200MCG","30","Select","Select",""],["","00023649810","UBRELVY","TAB 50MG","10","Select","Select",""],["","00378456105","POT CHLORIDE","TAB 10MEQ ER","14","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","27808023302","DOXYCYCL HYC","CAP 100MG","14","Select","Select",""],["","72618300002","NURTEC","TAB 75MG ODT","8","Select","Select",""],["","43547039910","CYCLOBENZAPR","TAB 5MG","90","Select","Select",""],["","65862050320","AMOX\/K CLAV","TAB 875-125","14","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","80681002500","VITAMIN B-6","TAB 100MG","30","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","65862053750","LEVOFLOXACIN","TAB 500MG","10","Select","Select",""],["","27241015504","OXYBUTYNIN CHLORIDE ER","5 MG","30","Select","Select",""],["","65162062750","TRAMADOL HCL","50 MG","30","Select","Select",""],["","65862049501","QUETIAPINE FUMARATE","400 MG","30","Select","Select",""],["","69547035302","NARCAN","4 MG","2","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","00406800330","MORPHINE SULFATE","100 MG\/5ML","30","Select","Select",""],["","43547039910","CYCLOBENZAPRINE HCL","5 MG","90","Select","Select",""],["","65862017760","CEFDINIR","300 MG","14","Select","Select",""],["","65862016001","ZOLPIDEM TARTRATE","10 MG","30","Select","Select",""],["","00310461612","BREZTRI AEROSPHERE","160-9-4.8","10.7","Select","Select",""],["","27808023302","DOXYCYCLINE HYCLATE","100 MG","14","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":""}]}]}