{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JIMMIE  E ROBERTSON","gend":0,"add":"147 WORSHAM ROAD","city":"FARMVILLE","state":"VA","zip":"23901-9998","dob":"1962-11-29","age":"","mstatus":"","insh":"20072673*01","cliId":"","pno":4343904697,"cno":4343904697,"email":"","ename":"","eno":"","pphy":"BAILEY, PAUL A MD","ppno":4346366903,"pcpadd":"9782 HIGHWAY NINE O THREE,","pcpcity":"BRACEY","pcpstate":"VA","pcpzip":"23919-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4346363826,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","Z72.0","E11.40","Z79.4","E11.59","E11.69","E78.5","G89.4","I72.4","F33.2","J44.9","J45.909","L60.0","B35.1","E11.49","E11.42","Z23.","G47.30","Z00.00","G62.9","Z12.5","Z12.11","NO DATA","J20.9","R05.","D12.0","K64.1","K57.30","Z86.010","J44.1","R93.89","G47.33","R06.00","F17.290","J45.20","Z79.2","Z79.52","R07.9","D75.89","I73.9","I82.4Z9","I70.229","M79.7","D12.6","F41.9","F10.21","F12.90","M25.071","G60.0","E11.9","I50.9","M79.605","B35.3","K64.4","R05.9","R06.09","Z72.821","J01.01","Z12.2","R91.1","Z87.891","M79.644","Z86.39","Z86.69","F17.210"],"date":["2023-04-18","2022-03-29","2021-02-08","2021-02-08","2022-03-29","2023-04-18","2021-02-08","2021-07-14","2022-05-02","2022-03-29","2021-11-01","2021-02-08","2023-05-17","2023-05-17","2023-05-17","2023-04-18","2022-12-13","2023-04-18","2022-08-09","2022-08-09","2022-08-09","2022-09-15","2023-04-18","2021-04-29","2021-07-14","2022-09-15","2022-09-15","2022-09-15","2022-09-15","2022-10-07","2021-11-01","2022-08-29","2021-09-08","2023-05-13","2022-10-07","2022-10-07","2022-10-07","2021-11-01","2022-05-02","2022-05-02","2022-05-02","2023-04-18","2022-05-02","2022-08-24","2021-07-14","2022-03-29","2021-07-14","2021-03-17","2021-03-17","2022-03-09","2022-01-28","2021-02-05","2022-02-02","2022-09-15","2021-11-01","2022-03-09","2022-03-29","2023-04-18","2021-06-16","2021-06-16","2021-06-16","2023-05-13","2023-05-13","2023-05-13","2023-05-13"],"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":[["","27241009803","DULOXETINE","CAP 30MG","90","Select","Select",""],["","68645058259","METFORMIN","TAB 500MG","60","Select","Select",""],["","27241010806","CLONIDINE","TAB 0.1MG ER","30","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","60505024801","MIRTAZAPINE","30 MG","90","Select","Select",""],["","00228202710","ALPRAZOLAM","0.25 MG","60","Select","Select",""],["","70710168400","FAMOTIDINE","40 MG","90","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","68382080701","TRAZODONE","TAB 150MG","135","Select","Select",""],["","59746017310","PREDNISONE","TAB 10MG","20","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","69238110002","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","50228018005","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","68645055354","LISINOPRIL","20 MG","90","Select","Select",""],["","68462025501","ROPINIROLE","TAB 1MG","270","Select","Select",""],["","69452014430","BENZONATATE","CAP 200MG","42","Select","Select",""],["","00603548321","PROPRANOLOL","TAB 20MG","180","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","31722072250","LEVOFLOXACIN","TAB 500MG","7","Select","Select",""],["","00597015561","STIOLTO","AER 2.5-2.5","4","Select","Select",""],["","76204020060","ALBUTEROL","NEB 0.00083","180","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","64380076921","PEG-3350\/KCL","SOL \/SODIUM","4000","Select","Select",""],["","50111078751","AZITHROMYCIN","250 MG","6","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","29300022019","MONTELUKAST SODIUM","10 MG","90","Select","Select",""],["","68462025501","ROPINIROLE HCL","1 MG","90","Select","Select",""],["","27241010806","CLONIDINE HCL ER","0.1 MG","30","Select","Select",""],["","00603548321","PROPRANOLOL HCL","20 MG","180","Select","Select",""],["","68645058259","METFORMIN HCL","500 MG","60","Select","Select",""],["","68382080701","TRAZODONE HCL","150 MG","135","Select","Select",""],["","27241009803","DULOXETINE HCL","30 MG","90","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","68382080701","TRAZODONE TAB","150MG","135","Select","Select",""],["","00603548321","PROPRANOLOL TAB","20MG","180","Select","Select",""],["","29300022019","MONTELUKAST TAB","10MG","90","Select","Select",""],["","27241010806","CLONIDINE TAB","0.1MG ER","30","Select","Select",""],["","68462025501","ROPINIROLE TAB","1MG","270","Select","Select",""],["","27241009803","DULOXETINE CAP","30MG","90","Select","Select",""],["","68645055354","LISINOPRIL TAB","20MG","90","Select","Select",""],["","00487950103","ALBUTEROL NEB","0.083%","300","Select","Select",""],["","68645058259","METFORMIN TAB","500MG","60","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","63304069301","CLINDAMYCIN CAP","300MG","21","Select","Select",""],["","00116200116","CHLORHEX GLU SOL","0.12%","473","Select","Select",""],["","68645056354","IBUPROFEN TAB","800MG","20","Select","Select",""],["","00228202710","ALPRAZOLAM TAB","0.25MG","60","Select","Select",""],["","70710168400","FAMOTIDINE TAB","40MG","30","Select","Select",""],["","60505024801","MIRTAZAPINE TAB","30MG","90","Select","Select",""],["","00781261305","AMOXICILLIN CAP","500MG","21","Select","Select",""],["","67877021905","CEPHALEXIN CAP","500MG","14","Select","Select",""],["","42806040021","METHYLPRED TAB","4MG","21","Select","Select",""],["","50111078751","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","64380076921","PEG-","3350\/KCL SOL \/SODIUM","4000","Select","Select",""],["","69452014430","BENZONATATE CAP","200MG","42","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":""}]}]}