{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EMILY  K PIERCE","gend":1,"add":"276 VIRGINIA AVE NE APT 276","city":"NORTON","state":"VA","zip":"24273-9998","dob":"1996-12-23","age":"","mstatus":"","insh":"20073273*01","cliId":"","pno":8126867714,"cno":8126867714,"email":"","ename":"","eno":"","pphy":"ROWE, TAYLOR R NP","ppno":2763250121,"pcpadd":"610 PARK AVE NW,","pcpcity":"NORTON","pcpstate":"VA","pcpzip":"24273-9998","pcpcounty":"","pcpid":"","pcpname":"Kumar Quality Medical Care","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2763250172,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":[]}]},{"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":[["","65162089803","ARIPIPRAZOLE","TAB 10MG","30","Select","Select",""],["","68180035302","SERTRALINE","TAB 100MG","45","Select","Select",""],["","50111056102","TRAZODONE","TAB 100MG","30","Select","Select",""],["","00378116580","BUSPIRONE","TAB 15MG","90","Select","Select",""],["","50111064844","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","45","Select","Select",""],["","45802011222","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","65162044210","MECLIZINE","TAB 25MG","30","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","49884046665","CHOLESTYRAM","POW 4GM LITE","60","Select","Select",""],["","00115521116","COLESTIPOL","TAB 1GM","60","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","00185067401","HYDROXYZ PAM","CAP 25MG","30","Select","Select",""],["","67877025115","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","00904681552","MUCUS RELIEF","TAB 400MG","60","Select","Select",""],["","00006505506","LAGEVRIO","CAP 200MG","40","Select","Select",""],["","00574082001","TESTOST CYP","INJ 200MG\/ML","2","Select","Select",""],["","69238207707","PROPRANOLOL","TAB 10MG","45","Select","Select",""],["","08290305145","BD NEEDLE","MIS 23GX1\"","2","Select","Select",""],["","08290305195","BD HYPO NEED","MIS 18GX1\"","2","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","00574082001","TESTOSTERONE CYPIONATE","200 MG\/ML","2","Select","Select",""],["","00378116580","BUSPIRONE HCL","15 MG","90","Select","Select",""],["","50111056102","TRAZODONE HCL","100 MG","30","Select","Select",""],["","08290305127","REGULAR BEVEL NEEDLES","25GX1 1\/2\"","2","Select","Select",""],["","00115165903","PROPRANOLOL HCL","10 MG","45","Select","Select",""],["","00185012201","NITROFURANTOIN MONO-MACRO","100 MG","14","Select","Select",""],["","08290305145","NEEDLE","23GX1\"","2","Select","Select",""],["","00603254428","BUTALBITAL-ACETAMINOPHEN-CAFFE","50-325-40","15","Select","Select",""],["","75826011510","PHENAZOPYRIDINE HCL","200 MG","6","Select","Select",""],["","65162027250","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","10","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":""}]}]}