{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANTOINE FLYNN","gend":0,"add":"15 4TH ST SE","city":"PULASKI","state":"VA","zip":"24301-9998","dob":"1969-08-22","age":"","mstatus":"","insh":"20051264*01","cliId":"","pno":5407390607,"cno":5407390607,"email":"","ename":"","eno":"","pphy":"GILLESPIE, KRISTIE M NP","ppno":5408350500,"pcpadd":"28 TOWN CENTER DRIVE,","pcpcity":"DUBLIN","pcpstate":"VA","pcpzip":"24084-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5403075050,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","I73.9","B19.20","G62.9","G47.33","Z68.36","R60.0","G89.29","F32.9","F43.10","F17.200","I89.0","L02.91","L29.9","E16.2","E55.9","E53.8","K80.20","N20.0","N39.0","I10.","R39.15","R73.9","Z79.899","R53.83","Z23.","L81.8","Z78.9","Z87.898","B18.2","R30.0","NO DATA","Z68.37","M79.89","L53.9","M86.9","M48.04","R27.8","M46.45","M46.24","M54.9","K74.60","F11.90","K21.9","M46.40","D61.818","M46.49","I87.2","M48.00","N40.0","Z91.199","F19.10","M46.20","K05.10","Z86.19","Z76.0","N40.1"],"date":["2023-01-09","2022-10-28","2023-08-10","2023-08-10","2021-03-01","2022-08-25","2023-08-10","2023-06-27","2022-10-28","2023-09-08","2023-06-23","2023-04-05","2022-08-25","2022-07-01","2022-10-28","2022-10-28","2022-07-01","2023-03-03","2023-03-03","2023-03-03","2023-06-24","2023-03-03","2022-10-28","2022-09-08","2022-10-28","2022-10-28","2021-11-15","2023-09-07","2021-11-15","2021-11-15","2023-01-14","2023-08-10","2022-06-23","2022-07-01","2022-07-01","2023-07-13","2023-06-26","2023-06-22","2023-06-24","2023-07-05","2023-06-27","2023-06-29","2023-06-26","2023-06-23","2023-06-26","2023-09-08","2023-06-23","2023-06-23","2023-06-23","2023-06-24","2023-06-23","2023-06-23","2023-09-08","2023-09-08","2023-09-08","2023-09-07","2023-09-07"],"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":[["","68462018022","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","61958220101","EPCLUSA","TAB 400-100","28","Select","Select",""],["","72626270101","SOFOS\/VELPAT","TAB 400-100","28","Select","Select",""],["","43598021040","SSD","CRE 0.01","60","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","43547040111","FUROSEMIDE","20 MG","60","Select","Select",""],["","16714008211","HYDROXYZ HCL","TAB 25MG","30","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","10006073038","MAG OXIDE","TAB 400MG","60","Select","Select",""],["","68382032010","POT CHLORIDE","TAB 10MEQ ER","30","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","04910040009",""," ","30","Select","Select",""],["","50428032287","PROBIOTIC","CAP MAX STR","30","Select","Select",""],["","16714047701","AMOX\/K CLAV","TAB 500-125","14","Select","Select",""],["","00193962801","CONTOUR","KIT NEXT EZ","1","Select","Select",""],["","56151147004","TRUE METRIX","KIT METER","1","Select","Select",""],["","53885004401","ONE TOUCH","KIT VERIO FL","1","Select","Select",""],["","53885001110","ONETOUCH DEL","MIS PLUS 30G","100","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","50","Select","Select",""],["","16571041250","CIPROFLOXACIN HCL","500 MG","20","Select","Select",""],["","75826011510","PHENAZOPYRIDINE HCL","200 MG","9","Select","Select",""],["","00093314701","CEPHALEXIN","500 MG","28","Select","Select",""],["","00378456105","POTASSIUM CHLORIDE","10 MEQ","30","Select","Select",""],["","16714015901","ONDANSETRON HCL","4 MG","9","Select","Select",""],["","47781030301","NITROFURANTOIN MONO-MACRO","100 MG","28","Select","Select",""],["","16714071301","TAMSULOSIN HCL","0.4 MG","7","Select","Select",""],["","00406012410","HYDROCODONE-ACETAMINOPHEN","7.5-325 MG","10","Select","Select",""],["","68462018022","MUPIROCIN OIN","2%","22","Select","Select",""],["","72626270101","SOFOS\/VELPAT TAB","400-100","28","Select","Select",""],["","61958220101","EPCLUSA TAB","400-100","28","Select","Select",""],["","10006073038","MAG OXIDE TAB","400MG","60","Select","Select",""],["","43547040111","FUROSEMIDE TAB","20MG","60","Select","Select",""],["","16714008211","HYDROXYZ HCL TAB","25MG","30","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","43598021040","SSD CRE","1%","60","Select","Select",""],["","68180096301","ALBUTEROL AER HFA","","8","Select","Select",""],["","00173068220","VENTOLIN HFA AER","","18","Select","Select",""],["","70010002201","POT CHLORIDE TAB","10MEQ ER","30","Select","Select",""],["","65862007701","CIPROFLOXACN TAB","500MG","14","Select","Select",""],["","16714047701","AMOX\/K CLAV TAB","500-125","14","Select","Select",""],["","53885027150","ONETOUCH TES VERIO","","50","Select","Select",""],["","50428032287","PROBIOTIC CAP MAX STR","","30","Select","Select",""],["","53885004401","ONE TOUCH KIT VERIO FL","","1","Select","Select",""],["","53885001110","ONETOUCH DEL MIS PLUS","30G","100","Select","Select",""],["","56151147004","TRUE METRIX KIT METER","","1","Select","Select",""],["","00193962801","CONTOUR KIT NEXT EZ","","1","Select","Select",""],["","47781042647","FENTANYL","50MCG\/HR","2","Select","Select",""],["","00135019402","NICODERM CQ","21 MG\/24HR","21","Select","Select",""],["","00406851501","OXYCODONE HCL","15 MG","7","Select","Select",""],["","43598044870","NICOTINE PATCH","21 MG\/24HR","21","Select","Select",""],["","11917007508","MELATONIN","3 MG","5","Select","Select",""],["","41167005840","ASPERCREME LIDOCAINE","4 %","5","Select","Select",""],["","65862050320","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","14","Select","Select",""],["","70010077001","METHOCARBAMOL","750 MG","90","Select","Select",""],["","27241009803","DULOXETINE HCL","30 MG","30","Select","Select",""],["","68382005105","MELOXICAM","15 MG","30","Select","Select",""],["","68382085701","TRIAMTERENE-HYDROCHLOROTHIAZID","75 MG-50MG","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":""}]}]}