{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRIGITTE  A BROWN","gend":1,"add":"1131 VALANCE DR","city":"VANSANT","state":"VA","zip":"24656-9998","dob":"1971-05-22","age":"","mstatus":"","insh":"20064634*01","cliId":"","pno":2763123274,"cno":2763123274,"email":"","ename":"","eno":"","pphy":"VIERS, HENRY P NP","ppno":2768657155,"pcpadd":"23660 DICKENSON HWY","pcpcity":"HAYSI","pcpstate":"VA","pcpzip":"24256-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2768657996,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I73.9","U07.1","J40.","M72.2","D86.9","M19.90","K58.9","Z86.39","I10.","E78.5","E11.9","F32.9","L29.9","B37.0","R11.0","J30.2","Z71.89","Z13.89","Z13.9","Z00.8","E11.65","Z79.4","M54.2","E55.9","Z79.891","E61.2","D51.9","Z79.899","Z79.52","M79.672","M79.671","E11.42","M87.059","M25.551","M25.552","M87.852","J18.9","Z23.","M62.830","K21.9","E83.42","D72.829","E66.01","F19.20","H66.93","R05.9","F17.210","Z79.84","Z79.01"],"date":["2022-06-01","2022-09-06","2022-09-06","2022-06-13","2023-01-09","2023-01-09","2022-07-15","2022-07-15","2023-01-09","2023-01-09","2023-01-09","2023-01-09","2022-07-15","2023-01-09","2023-01-09","2023-01-09","2021-06-23","2021-06-23","2021-06-23","2021-06-23","2021-06-23","2022-09-06","2021-06-23","2021-06-23","2021-06-23","2021-06-23","2021-06-23","2022-12-19","2021-11-03","2022-06-13","2022-06-13","2022-06-13","2022-10-24","2022-11-10","2022-11-10","2022-11-10","2022-07-15","2022-11-07","2023-01-09","2023-01-09","2023-01-09","2022-01-10","2022-01-10","2022-01-10","2022-05-16","2022-09-06","2022-09-06","2022-09-06","2022-09-06"],"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":[["","63004871001","ACTHAR","INJ 80UNIT","5","Select","Select",""],["","00378932132","WIXELA INHUB","AER 250\/50","60","Select","Select",""],["","53746051105","SPIRONOLACT","TAB 25MG","15","Select","Select",""],["","62175013643","OMEPRAZOLE","40 MG","30","Select","Select",""],["","23155010405","METFORMIN","TAB 1000MG","60","Select","Select",""],["","57896063412","MAG OXIDE","TAB 400MG","60","Select","Select",""],["","65862052301","GABAPENTIN","600 MG","90","Select","Select",""],["","57664037718","TRAMADOL HCL","50 MG","120","Select","Select",""],["","00378258701","HYDROXYZ HCL","TAB 25MG","90","Select","Select",""],["","50742061610","METOPROL SUC","TAB 50MG ER","60","Select","Select",""],["","50458057930","XARELTO","20 MG","30","Select","Select",""],["","57237000511","FLUCONAZOLE","150 MG","8","Select","Select",""],["","69097082112","GEMFIBROZIL","600 MG","60","Select","Select",""],["","60505025203","TIZANIDINE","TAB 4MG","90","Select","Select",""],["","55111032205","GLIMEPIRIDE","4 MG","60","Select","Select",""],["","60505258009","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","65862001205","SERTRALINE","TAB 50MG","60","Select","Select",""],["","45963053830","ONDANSETRON","TAB 4MG","12","Select","Select",""],["","91237000170","EASY COMFORT","MIS 31GX5\/16","100","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","9","Select","Select",""],["","00591352530","LIDOCAINE","5 %","30","Select","Select",""],["","68382004110","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","00378602501","CEPHALEXIN","250 MG","30","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00574402435","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","00603533732","PREDNISONE","5 MG","90","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00071080524","NEURONTIN","CAP 300MG","60","Select","Select",""],["","00781165501","PENICILLN VK","TAB 500MG","20","Select","Select",""],["","00185067405","HYDROXYZ PAM","CAP 25MG","90","Select","Select",""],["","00591367105","NABUMETONE","750 MG","60","Select","Select",""],["","00169368712","LEVEMIR","100\/ML","10","Select","Select",""],["","00173069600","ADVAIR DISKU","AER 250\/50","60","Select","Select",""],["","00548560500","ENOXAPARIN","INJ 100MG\/ML","10","Select","Select",""],["","00832046560","NYAMYC","POW 100000","60","Select","Select",""],["","00378003210","METOPROL TAR","TAB 50MG","60","Select","Select",""],["","00904423960","MAGNESIUM","TAB 500MG","60","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","3","Select","Select",""],["","68180016006","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00074055402","HUMIRA PEN","INJ 40\/0.4ML","1","Select","Select",""],["","45802065087","LORATADINE","10 MG","30","Select","Select",""],["","65162044211","MECLIZINE","TAB 25MG","90","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","20","Select","Select",""],["","24208063110","NEO\/POLY\/HC","SOL 1% OTIC","10","Select","Select",""],["","68308015260","NYSTATIN","100000\/G","60","Select","Select",""],["","51672129803","KETOCONAZOLE","CRE 0.02","60","Select","Select",""],["","00781185220","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","49100040009","CULTURELLE","CAP ","30","Select","Select",""],["","69452014330","BENZONATATE","100 MG","30","Select","Select",""],["","00591569550","MINOCYCLINE","CAP 100MG","14","Select","Select",""],["","00536105907","PROBIOTIC","CAP FORMULA","30","Select","Select",""],["","00487020103","IPRATROPIUM\/","SOL ALBUTER","180","Select","Select",""],["","68180024220","LEVOFLOXACIN","750 MG","7","Select","Select",""],["","31722055190","LEVOCETIRIZINE DIHYDROCHLORIDE","5 MG","30","Select","Select",""],["","29300022010","MONTELUKAST SODIUM","10 MG","30","Select","Select",""],["","76204010025","IPRATROPIUM BROMIDE","0.2 MG\/ML","125","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","91237000170","EASY COMFORT PEN NEEDLE","31 GX5\/16\"","100","Select","Select",""],["","00904423960","MAGNESIUM OXIDE","500 MG","60","Select","Select",""],["","00093506105","HYDROXYZINE HCL","25 MG","90","Select","Select",""],["","65862001205","SERTRALINE HCL","50 MG","60","Select","Select",""],["","00591569550","MINOCYCLINE HCL","100 MG","14","Select","Select",""],["","60505025203","TIZANIDINE HCL","4 MG","90","Select","Select",""],["","50742061610","METOPROLOL SUCCINATE","50 MG","60","Select","Select",""],["","00093316006","CEFDINIR","300 MG","20","Select","Select",""],["","00169643810","LEVEMIR FLEXTOUCH","100\/ML (3)","12","Select","Select",""],["","00169633910","NOVOLOG FLEXPEN","100\/ML (3)","3","Select","Select",""],["","65162044211","MECLIZINE HCL","25 MG","90","Select","Select",""],["","60505317007","OMEGA-","3 ACID ETHYL ESTERS 1 G","120","Select","Select",""],["","60505258009","ATORVASTATIN CALCIUM","40 MG","30","Select","Select",""],["","43547040611","CLONAZEPAM","0.5 MG","10","Select","Select",""],["","68382004110","PROMETHAZINE HCL","25 MG","30","Select","Select",""],["","53746051105","SPIRONOLACTONE","25 MG","15","Select","Select",""],["","00378718705","METFORMIN HCL","1000 MG","60","Select","Select",""],["","27808006502","PROMETHAZINE-CODEINE","6.25-10\/5","200","Select","Select",""],["","00487950125","ALBUTEROL SULFATE","2.5 MG\/3ML","180","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":""}]}]}