{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEBBIE  J GILLENWATER","gend":1,"add":"308 WILLOW ST APT 103","city":"GATE CITY","state":"VA","zip":"24251-9998","dob":"1962-03-12","age":"","mstatus":"","insh":"20048078*01","cliId":"","pno":2762481992,"cno":2762481992,"email":"","ename":"","eno":"","pphy":"CARTER, ALYSEN M MD","ppno":2763863411,"pcpadd":"390 KANE STREET,","pcpcity":"GATE CITY","pcpstate":"VA","pcpzip":"24251-9998","pcpcounty":"","pcpid":"","pcpname":"Mountain Region Family Medicine (Lab)","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2763863492,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I25.2","I65.23","M79.602","E78.5","I10.","Z79.82","Z79.899","Z79.02","F17.210","Z53.20","R11.0","F33.2","F41.1","F10.21","F13.10","NO DATA","I70.223","R32.","R07.2","R07.9","R22.2","R00.0","R06.02","I25.10","I73.9","R94.31","I77.9","R11.2","R07.89","J81.0","G89.29","R06.00","R94.39","E78.2","R10.10","F41.9","K21.9","J43.9","F33.9","F31.9","R91.1","G47.9","F17.200","Z68.28","F99.","R45.7","R45.0","Z23.","N39.3","Z68.26","M51.9","F33.1"],"date":["2021-12-16","2023-02-17","2021-12-16","2022-12-01","2023-05-17","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2022-02-18","2022-12-29","2022-02-18","2022-01-20","2023-06-26","2022-10-14","2023-06-12","2021-05-17","2021-05-19","2021-05-17","2021-05-17","2021-05-17","2022-12-29","2023-06-26","2021-05-17","2023-02-17","2021-02-08","2021-05-19","2021-05-18","2021-05-19","2021-05-19","2021-06-02","2021-06-02","2022-04-14","2022-04-14","2023-06-26","2023-06-26","2022-12-29","2023-06-26","2022-12-29","2022-12-29","2022-12-29","2023-06-26","2022-04-14","2022-04-14","2022-04-14","2022-12-01","2022-12-01","2022-12-01","2023-03-06","2023-06-26"],"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":[["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","68180098003","LISINOPRIL","10 MG","30","Select","Select",""],["","00378668977","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","26","Select","Select",""],["","13107000130","MIRTAZAPINE","7.5 MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","90","Select","Select",""],["","31722088390","ROSUVASTATIN","TAB 10MG","90","Select","Select",""],["","23155050105","HYDROXYZ HCL","TAB 25MG","30","Select","Select",""],["","60505082901","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","43598083305","ATORVASTATIN CALCIUM","80 MG","30","Select","Select",""],["","42571012290","LEVOCETIRIZINE DIHYDROCHLORIDE","5 MG","30","Select","Select",""],["","67877043103","ARIPIPRAZOLE","5 MG","30","Select","Select",""],["","11917011208","DELUXE ARM BP MONITOR","","1","Select","Select",""],["","68180072103","AMLODIPINE BESYLATE","10 MG","30","Select","Select",""],["","68462016305","CARVEDILOL","6.25 MG","60","Select","Select",""],["","43598081115","CETIRIZINE HCL","10 MG","90","Select","Select",""],["","65862035705","CLOPIDOGREL","75 MG","30","Select","Select",""],["","43598044874","NICOTINE PATCH","21 MG\/24HR","28","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","68462026290","ROSUVASTATIN CALCIUM","10 MG","90","Select","Select",""],["","00135057602","FLONASE ALLERGY RELIEF","50 MCG","29.7","Select","Select",""],["","00378668977","PANTOPRAZOLE SODIUM","40 MG","30","Select","Select",""],["","68180072103","AMLODIPINE TAB","10MG","90","Select","Select",""],["","00093317431","ALBUTEROL AER HFA","","26","Select","Select",""],["","31722088390","ROSUVASTATIN TAB","10MG","90","Select","Select",""],["","68180098103","LISINOPRIL TAB","20MG","30","Select","Select",""],["","00378668977","PANTOPRAZOLE TAB","40MG","30","Select","Select",""],["","13107000130","MIRTAZAPINE TAB","7.5MG","30","Select","Select",""],["","00054327099","FLUTICASONE SPR","50MCG","32","Select","Select",""],["","43598081115","CETIRIZINE TAB","10MG","30","Select","Select",""],["","23155050105","HYDROXYZ HCL TAB","25MG","30","Select","Select",""],["","70700015010","OMEPRAZOLE","20 MG","90","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":""}]}]}