{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"FELICIA CARTER SCOTT","gend":1,"add":"316 ARTIS ST","city":"FRANKLIN","state":"VA","zip":"23851-9998","dob":"1970-12-15","age":"","mstatus":"","insh":"20061419*01","cliId":"","pno":7575563671,"cno":7575563671,"email":"","ename":"","eno":"","pphy":"DAYMOND, EMMA F MD","ppno":7575622158,"pcpadd":"102 FAIRVIEW DR STE B,","pcpcity":"FRANKLIN","pcpstate":"VA","pcpzip":"23851-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7575168019,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.0","M25.561","R60.0","F14.20","I10.","R73.03","Z12.31","Z68.23","Z12.11","Z86.2","J30.89","J06.9","M17.12","M17.11","B37.9","T36.95XA","E11.9","H25.13","H47.233","H52.7","M54.12","F17.210","Z79.899","R20.0","R53.83","G56.23","M17.0","R05.1","J44.1","Z20.822","R05.","R19.7","M23.221","S86.911A","J20.9","R06.2","R07.81","J90.","Z79.1","R07.9","K57.90","K64.9","Z13.220","R68.89","E55.9","Z68.21","M54.2","G56.22","K57.30","K64.0","S46.811A","M62.838","M79.642","M79.641","V58.89","F17.219","Z09.","G89.29"],"date":["2022-12-01","2023-06-13","2021-07-19","2023-07-19","2023-06-13","2022-11-23","2022-04-04","2022-04-04","2022-08-09","2022-11-23","2022-11-23","2022-12-03","2022-04-04","2023-03-30","2022-04-04","2022-04-04","2022-04-19","2022-04-19","2022-04-22","2022-04-19","2023-02-27","2023-06-13","2023-06-13","2023-02-27","2022-12-03","2023-04-02","2022-07-19","2023-04-07","2023-04-07","2021-02-01","2021-07-07","2021-02-01","2021-08-03","2021-06-17","2021-07-07","2022-11-23","2021-09-08","2021-09-08","2023-06-13","2021-09-08","2022-08-09","2022-08-09","2022-11-23","2022-11-23","2022-11-23","2022-11-23","2023-03-08","2023-03-08","2022-08-09","2022-08-09","2023-02-01","2023-02-01","2023-04-02","2023-04-02","2021-09-13","2021-09-13","2021-09-13","2023-06-13"],"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":[["","67877024601","QUETIAPINE","TAB 200MG","90","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","15","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","60","Select","Select",""],["","57237000511","FLUCONAZOLE","150 MG","2","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","65862001705","AMOXICILLIN","CAP 500MG","20","Select","Select",""],["","65862077930","OLM MED\/HCTZ","TAB 20-12.5","90","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","60505082901","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","65162062750","TRAMADOL HCL","50 MG","60","Select","Select",""],["","55111018015","TIZANIDINE HCL","4 MG","60","Select","Select",""],["","00536589671","NICOTINE PATCH","21 MG\/24HR","28","Select","Select",""],["","65862077930","OLMESARTAN-HYDROCHLOROTHIAZIDE","20-12.5 MG","90","Select","Select",""],["","67877024601","QUETIAPINE FUMARATE","200 MG","90","Select","Select",""],["","68462019005","NAPROXEN","500 MG","60","Select","Select",""],["","70954006020","PREDNISONE","20 MG","10","Select","Select",""],["","00406012305","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","12","Select","Select",""],["","45963055650","GABAPENTIN","300 MG","60","Select","Select",""],["","70010019905","GUAIFENESIN ER","600 MG","14","Select","Select",""],["","00591352530","LIDOCAINE","5 %","30","Select","Select",""],["","00378113401","KETOROLAC TROMETHAMINE","10 MG","15","Select","Select",""],["","67877024601","QUETIAPINE TAB","200MG","90","Select","Select",""],["","60505082901","FLUTICASONE SPR","50MCG","32","Select","Select",""],["","65862001705","AMOXICILLIN CAP","500MG","20","Select","Select",""],["","65862077930","OLM MED\/HCTZ TAB","20-12.5","90","Select","Select",""],["","57237000511","FLUCONAZOLE TAB","150MG","2","Select","Select",""],["","68180072103","AMLODIPINE TAB","10MG","90","Select","Select",""],["","70010077001","METHOCARBAM TAB","750MG","15","Select","Select",""],["","64380080807","IBUPROFEN TAB","600MG","20","Select","Select",""],["","68382005105","MELOXICAM TAB","15MG","30","Select","Select",""],["","66993001968","ALBUTEROL AER HFA","","18","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","17","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":""}]}]}