{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KERRY  L SMITH","gend":0,"add":"77 ELM STREET APT 3 ALBERTA MANOR","city":"ALBERTA","state":"VA","zip":"23821-9998","dob":"1975-03-20","age":"","mstatus":"","insh":"20055101*01","cliId":"","pno":4347746506,"cno":4347746506,"email":"","ename":"","eno":"","pphy":"ADARKWAH, OBED MD","ppno":4345842273,"pcpadd":"1755 N MECKLENBURG AVE","pcpcity":"SOUTH HILL","pcpstate":"VA","pcpzip":"23970-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4345845543,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.0","I10.","J44.9","F31.4","M67.911","M75.101","H61.22","H92.02","K04.7","J02.9","K02.9","F17.210","Z86.79","M25.50","G47.33","F17.200","F31.32","F41.1","I08.2","M54.5","G89.29","G62.9","R26.89","M62.81","E66.01","Z68.35","Z79.82","L70.0","L03.811","Z79.899","M25.511","M47.812","I25.10","H53.2","G90.09","M54.9","D51.9","F31.9","M75.41","M19.011","R20.0","R20.2","M06.89","M19.90","F33.41","R07.9","R00.2","R06.02","R06.2","I51.89","F41.9","E66.9","H93.19","F10.10","F98.9","R09.02","H02.421","R40.0","Z68.41","R05.","I11.9","E78.5","G89.4","M54.2","H04.123","H40.023","H52.4","J45.909","R29.6","M54.12","M54.16","H66.10","R74.8","E53.8","R00.0","M19.91","R52.","M62.830","M77.51","M77.52","NO DATA","M43.06","M43.02","E11.9","U07.1","M75.111"],"date":["2023-03-28","2022-08-26","2022-08-17","2022-07-19","2023-01-31","2022-08-30","2022-08-26","2022-08-26","2022-08-26","2022-08-26","2022-08-26","2022-08-26","2022-08-26","2023-03-29","2023-04-04","2022-10-14","2023-04-03","2023-04-03","2021-01-07","2021-08-05","2022-05-10","2023-03-29","2021-07-22","2021-08-05","2022-08-17","2021-07-22","2021-07-22","2021-08-18","2021-08-18","2022-06-23","2022-05-10","2022-02-17","2021-01-07","2021-05-13","2021-05-13","2022-03-10","2022-03-10","2022-04-11","2022-08-30","2022-08-30","2021-08-05","2021-08-05","2022-12-23","2022-12-23","2021-02-24","2021-08-06","2021-03-01","2021-05-25","2021-05-25","2021-05-25","2021-08-06","2021-05-25","2021-08-05","2021-08-05","2021-08-05","2021-08-05","2021-11-18","2022-06-23","2022-08-17","2021-03-02","2022-04-14","2021-05-21","2022-02-28","2022-02-28","2021-06-01","2021-06-01","2021-06-01","2021-07-13","2021-01-21","2021-03-24","2021-03-24","2022-01-18","2022-09-09","2022-09-09","2021-03-06","2022-04-14","2022-08-26","2023-02-09","2023-02-15","2023-02-15","2023-03-29","2023-03-29","2023-03-29","2023-01-19","2021-02-15","2023-01-31"],"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":[["","68180035309","SERTRALINE","TAB 100MG","45","Select","Select",""],["","70954001910","PRAZOSIN HCL","CAP 1MG","30","Select","Select",""],["","67877019905","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","00168000615","TRIAMCINOLON","OIN 0.001","60","Select","Select",""],["","57237001760","DULOXETINE","CAP 20MG","60","Select","Select",""],["","53489011905","DOXYCYCL HYC","CAP 100MG","14","Select","Select",""],["","65162089703","ARIPIPRAZOLE","5 MG","30","Select","Select",""],["","68382065005","ISOSORB MONO","TAB 30MG ER","30","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","30","Select","Select",""],["","63402030830","LATUDA","TAB 80MG","30","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","10006073043","VITAMIN B-12","TAB 1000MCG","90","Select","Select",""],["","59746017206","PREDNISONE","5 MG","180","Select","Select",""],["","65862059501","DIVALPROEX","TAB 500MG ER","30","Select","Select",""],["","42806016005","HYDROXYZ HCL","TAB 25MG","90","Select","Select",""],["","21922000201","CLINDAMYCIN","SOL 0.01","60","Select","Select",""],["","68382031818","MINOCYCLINE","CAP 100MG","60","Select","Select",""],["","00574222545","TRETINOIN","CRE 0.00025","45","Select","Select",""],["","70377000812","ROSUVASTATIN","TAB 20MG","90","Select","Select",""],["","80777027399","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","45802031801","BENZOYL PER","LIQ 10% WASH","142","Select","Select",""],["","50428046815","ACNE CLEANSI","BAR 0.1","1","Select","Select",""],["","50742061610","METOPROL SUC","TAB 50MG ER","90","Select","Select",""],["","51672136307","DICLOFENAC","GEL 0.03","100","Select","Select",""],["","16729018317","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","69680011225","CYANOCOBALAM","INJ 1000MCG","1","Select","Select",""],["","51991029301","OXCARBAZEPIN","TAB 300MG","60","Select","Select",""],["","00597002402","COMBIVENT","AER 20-100","4","Select","Select",""],["","70710160901","BACLOFEN","TAB 5MG","270","Select","Select",""],["","35046001130","B-12","SUB 1000MCG","30","Select","Select",""],["","65862052305","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","24208063562","NEO\/POLY\/HC","SUS 1% OTIC","10","Select","Select",""],["","00378247401","DICLOFEN POT","TAB 50MG","60","Select","Select",""],["","43547027010","ROPINIROLE","TAB 1MG","30","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","2","Select","Select",""],["","69584061250","METHOCARBAM","TAB 750MG","20","Select","Select",""],["","60505025103","TIZANIDINE","TAB 2MG","30","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","42571017410","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","23155000810","HYDROCHLOROTHIAZIDE","25 MG","30","Select","Select",""],["","69680011225","CYANOCOBALAMIN INJECTION","1000MCG\/ML","1","Select","Select",""],["","00597007541","SPIRIVA HANDIHALER","18 MCG","30","Select","Select",""],["","68180035309","SERTRALINE HCL","100 MG","45","Select","Select",""],["","60505258008","ATORVASTATIN CALCIUM","40 MG","30","Select","Select",""],["","67877019905","AMLODIPINE BESYLATE","10 MG","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":""}]}]}