{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHANNON YERIAN","gend":1,"add":"223 FLETCHER LN","city":"CASTLEWOOD","state":"VA","zip":"24224-9998","dob":"1976-11-25","age":"","mstatus":"","insh":"20070408*01","cliId":"","pno":2762102977,"cno":2762102977,"email":"","ename":"","eno":"","pphy":"EASTON, BRIAN THOMAS MD","ppno":2768893700,"pcpadd":"495 EAST MAIN ST,","pcpcity":"LEBANON","pcpstate":"VA","pcpzip":"24266-9998","pcpcounty":"","pcpid":"","pcpname":"Holston Medical Group PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2768895505,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H17.821","G56.02","K21.9","F31.9","E03.9","F33.1","F41.1","Z51.81","R51.9","M54.2","M54.5","M54.16","G43.109","R90.89","I10.","G56.03","M47.12","G89.29","R20.2","G43.111","R11.2","E87.6","G44.89","F11.21","R10.12","R10.32","B18.2","B19.20","R19.7","R21.","N39.3","Z12.11","R03.0","M47.812","M47.816","Z79.899","D18.00"],"date":["2022-02-22","2022-04-29","2023-08-15","2023-08-15","2023-08-15","2022-09-29","2023-05-09","2023-05-09","2022-09-24","2021-10-06","2021-07-15","2021-10-06","2022-09-29","2022-10-27","2023-08-15","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2022-09-25","2022-09-25","2022-09-25","2022-09-20","2023-01-10","2021-03-15","2021-03-15","2021-03-15","2022-09-24","2021-04-02","2021-07-22","2021-08-20","2021-04-02","2022-09-24","2022-03-31","2022-03-31","2023-05-09","2023-08-15"],"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":[["","68462022301","LITHIUM CARB","TAB 300MG ER","120","Select","Select",""],["","00093719801","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","69238183207","LEVOTHYROXIN","TAB 75MCG","90","Select","Select",""],["","45802086803","POLYETH GLYC","POW 3350 NF","510","Select","Select",""],["","68462039710","OMEPRAZOLE","40 MG","30","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","30","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","14","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","43386035610","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","00781183120","AMOX\/K CLAV","TAB 500-125","14","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","10","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","10702025350","BUT\/APAP\/CAF","TAB ","12","Select","Select",""],["","43547035211","LISINOPRIL","TAB 5MG","30","Select","Select",""],["","65862014736","SUMATRIPTAN","TAB 50MG","10","Select","Select",""],["","13668021930","ARIPIPRAZOLE","TAB 15MG","30","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","15","Select","Select",""],["","65862062690","RIZATRIPTAN","10 MG","10","Select","Select",""],["","00904530660","BANOPHEN","CAP 25MG","30","Select","Select",""],["","00093719801","FLUOXETINE HCL","40 MG","30","Select","Select",""],["","43598081115","CETIRIZINE HCL","10 MG","90","Select","Select",""],["","29300041901","AMITRIPTYLINE HCL","10 MG","30","Select","Select",""],["","68462022301","LITHIUM CARBONATE ER","300 MG","120","Select","Select",""],["","69238183207","LEVOTHYROXINE SODIUM","75 MCG","90","Select","Select",""],["","00002143611","EMGALITY PEN","120 MG\/ML","1","Select","Select",""],["","57237002801","AMOXICILLIN","500 MG","21","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":""}]}]}