{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHRISTOPHER  S EMMA","gend":0,"add":"260 N LEWIS ST","city":"STAUNTON","state":"VA","zip":"24450-9998","dob":"1980-08-01","age":"","mstatus":"","insh":"20051149*01","cliId":"","pno":5403486322,"cno":5403486322,"email":"","ename":"","eno":"","pphy":"MCCLUNG, WILLIAM MD","ppno":5404635055,"pcpadd":"204 E WASHINGTON ST,","pcpcity":"LEXINGTON","pcpstate":"VA","pcpzip":"24450-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5404631079,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F10.239","Z65.8","H00.011","H35.713","F33.2","F12.20","F10.24","F90.9","F41.1","F17.210","M26.609","F10.20","F39.","F41.8","F12.10","Z86.59","M41.9","R53.83","F33.1","Z20.822","B35.1","G47.9","M62.838","Z63.72","Z81.8","F10.229","F41.9","F10.10","F33.3","Z11.59","V62.84","Z79.899","NO DATA","G47.00","N23.","Z20.2","N52.9","Q55.22","R10.32","N20.0","F10.129","R45.1","F10.220","R61.","Y90.0","F32.9","S60.221A","M79.641","F51.01","H00.015","F51.04","R11.2","S90.861A","F31.81","W57.XXXA","G89.4","H57.13","M77.12","R20.2","K29.00","R10.13","R68.81","K40.90","K29.70","F31.9","Z88.8","R14.0","H00.012"],"date":["2021-12-04","2021-07-29","2021-09-06","2021-11-09","2021-12-02","2022-10-18","2021-12-02","2022-11-10","2022-10-18","2022-10-13","2021-12-06","2022-11-10","2021-06-10","2021-08-18","2021-07-28","2021-07-28","2021-12-02","2021-12-02","2022-10-18","2022-10-13","2022-10-13","2022-10-18","2022-10-18","2022-10-13","2022-10-13","2023-01-01","2022-06-17","2022-09-02","2021-07-22","2021-07-24","2021-07-25","2022-11-10","2023-05-12","2021-12-27","2022-03-25","2022-03-25","2021-08-11","2021-08-11","2022-03-25","2022-03-25","2022-08-06","2022-08-06","2022-08-07","2022-08-07","2022-08-07","2021-07-25","2021-07-17","2021-07-17","2021-12-09","2023-03-16","2022-06-17","2022-06-17","2021-06-01","2021-06-01","2021-06-01","2021-07-25","2023-05-12","2023-04-26","2023-06-12","2023-06-12","2023-06-08","2023-06-08","2023-06-08","2023-06-12","2023-06-12","2023-06-12","2023-06-12","2023-02-07"],"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":[["","50111056101","TRAZODONE","TAB 100MG","100","Select","Select",""],["","13107015490","PAROXETINE","TAB 10MG","30","Select","Select",""],["","42806034501","AMPHET\/DEXTR","TAB 30MG","30","Select","Select",""],["","57844013001","ADDERALL","TAB 30MG","60","Select","Select",""],["","59676058015","JANSSEN VACC","INJ COVID-19","0","Select","Select",""],["","00591354360","BUPROPION","TAB 150MG SR","60","Select","Select",""],["","00093534256","SILDENAFIL","TAB 50MG","10","Select","Select",""],["","14539067401","HYDROXYZ PAM","CAP 25MG","15","Select","Select",""],["","13107003134","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","13107008405","LORAZEPAM","1 MG","7","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","6","Select","Select",""],["","70069000701","OLOPATADINE","DRO 0.001","5","Select","Select",""],["","11534016503","FOLIC ACID","TAB 1MG","3","Select","Select",""],["","00761055520","VITAMIN B-1","TAB 100MG","30","Select","Select",""],["","70461032103","FLUCLVX QUAD","INJ 2021-22","0","Select","Select",""],["","80777027398","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","14","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","12","Select","Select",""],["","00054035613","DISULFIRAM","TAB 250MG","60","Select","Select",""],["","57896050410","ONE-DAILY","TAB MULT VIT","30","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","6","Select","Select",""],["","53489011905","DOXYCYCL HYC","CAP 100MG","28","Select","Select",""],["","00555003302","CHLORDIAZEP","CAP 10MG","120","Select","Select",""],["","16729008101","NALTREXONE","TAB 50MG","30","Select","Select",""],["","00228206710","OXAZEPAM","CAP 10MG","12","Select","Select",""],["","43598044774","NICOTINE TD","DIS 14MG\/24H","14","Select","Select",""],["","80777028299","MODERNA BIVA","INJ BA4\/BA5","0","Select","Select",""],["","49281042250","FLUZONE QUAD","INJ 2022-23","0","Select","Select",""],["","00536466110","THEREMS-M","TAB ","30","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","70010077005","METHOCARBAM","TAB 750MG","28","Select","Select",""],["","16729020101","BUSPIRONE","TAB 7.5MG","100","Select","Select",""],["","23155050110","HYDROXYZ HCL","TAB 25MG","30","Select","Select",""],["","67877024210","QUETIAPINE","TAB 25MG","30","Select","Select",""],["","16729008101","NALTREXONE HCL","50 MG","30","Select","Select",""],["","24208029005","TOBRAMYCIN","0.3 %","5","Select","Select",""],["","00172572880","FAMOTIDINE","20 MG","60","Select","Select",""],["","50111056101","TRAZODONE HCL","100 MG","100","Select","Select",""],["","21922000909","DICLOFENAC SODIUM","1 %","200","Select","Select",""],["","24208079535","NEOMYCIN-POLYMYXIN-DEXAMETH","3.5-10K-.1","3.5","Select","Select",""],["","53489011905","DOXYCYCL HYC CAP","100MG","28","Select","Select",""],["","16729030017","TRAZODONE TAB","100MG","30","Select","Select",""],["","00555003302","CHLORDIAZEP CAP","10MG","120","Select","Select",""],["","43598044774","NICOTINE TD DIS","14MG\/24H","14","Select","Select",""],["","00761055520","VITAMIN B-","1 TAB 100MG","30","Select","Select",""],["","00228206710","OXAZEPAM CAP","10MG","12","Select","Select",""],["","13107003134","MIRTAZAPINE TAB","15MG","30","Select","Select",""],["","00536466110","THEREMS-M TAB","","30","Select","Select",""],["","16729020101","BUSPIRONE TAB","7.5MG","100","Select","Select",""],["","67877024210","QUETIAPINE TAB","25MG","30","Select","Select",""],["","49281042250","FLUZONE QUAD INJ","2022-23","0","Select","Select",""],["","80777028299","MODERNA BIVA INJ BA","4\/BA5","0","Select","Select",""],["","16729008101","NALTREXONE TAB","50MG","30","Select","Select",""],["","67877032105","IBUPROFEN TAB","800MG","30","Select","Select",""],["","70010077005","METHOCARBAM TAB","750MG","28","Select","Select",""],["","11534016503","FOLIC ACID TAB","1MG","3","Select","Select",""],["","23155050110","HYDROXYZ HCL TAB","25MG","30","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":""}]}]}