{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANNA D HALL","gend":1,"add":"371 ASPEN ST APT D","city":"TAZEWELL","state":"VA","zip":"24651-9998","dob":"1990-01-10","age":"","mstatus":"","insh":"20076675*01","cliId":"","pno":2769701718,"cno":2769701718,"email":"","ename":"","eno":"","pphy":"JACKSON, KERRI S NP","ppno":2769799899,"pcpadd":"386 BEN BOLT AVE,","pcpcity":"TAZEWELL","pcpstate":"VA","pcpzip":"24651-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2769799798,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.0","F69.","R41.840","G47.9","R45.0","F90.9","U07.1","F31.2","F32.2","F41.1","V23.9","O20.0","N89.8","Z32.00","O21.9","S46.811A","M62.838","M54.5","F17.210","Z88.8","M25.511","R68.89","R05.9","O20.9","Z88.6","Z90.49","N93.9","S46.812A","M53.3","V89.2XXA","B37.0","F41.9","J45.909","J06.9","F32.1","M79.7","Z3A.01","O46.91","O46.90","L73.2","E28.2","J45.40","K21.9"],"date":["2022-04-05","2021-09-18","2021-09-18","2021-09-18","2021-09-18","2021-09-18","2022-02-01","2022-08-16","2022-04-05","2022-04-05","2023-01-19","2023-01-19","2023-01-19","2023-01-11","2023-01-19","2021-08-17","2021-08-17","2021-08-17","2021-09-18","2021-08-17","2021-08-17","2022-02-01","2022-02-01","2023-01-19","2023-01-10","2023-01-10","2023-01-10","2021-08-17","2021-08-17","2021-08-17","2021-10-05","2021-09-18","2021-09-18","2021-11-06","2022-05-10","2022-11-15","2023-01-10","2023-01-10","2023-01-10","2021-09-07","2021-09-07","2021-09-07","2021-09-07"],"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":[["","62175061743","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","70010006310","METFORMIN","TAB 500MG","180","Select","Select",""],["","52817033050","CYCLOBENZAPR","TAB 5MG","60","Select","Select",""],["","00378727253","NORETHINDRON","TAB 0.35MG","28","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","16729022616","SPIRONOLACT","TAB 50MG","90","Select","Select",""],["","42806071505","BENZONATATE","CAP 200MG","21","Select","Select",""],["","00185067405","HYDROXYZ PAM","CAP 25MG","120","Select","Select",""],["","65862019399","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","00121089316","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","30","Select","Select",""],["","59762501002","CLINDAMYCIN","CAP 300MG","28","Select","Select",""],["","00603459321","METHYLPRED","TAB 4MG","21","Select","Select",""],["","31722094905","OXYCOD\/APAP","TAB 5-325MG","16","Select","Select",""],["","49483060650","GABAPENTIN","300 MG","60","Select","Select",""],["","00591530710","PROMETHAZINE HCL","25 MG","30","Select","Select",""],["","51672130406","TERCONAZOLE","0.4 %","45","Select","Select",""],["","55111015810","OMEPRAZOLE","20 MG","30","Select","Select",""],["","00173068220","VENTOLIN HFA","90 MCG","18","Select","Select",""],["","65862019399","FLUOXETINE HCL","20 MG","30","Select","Select",""],["","57237007810","ONDANSETRON ODT","8 MG","30","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","57237023305","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","14","Select","Select",""],["","00536408501","PRENATAL VITAMINS","28MG-0.8MG","30","Select","Select",""],["","65862064130","AZITHROMYCIN","250 MG","6","Select","Select",""],["","45802065087","LORATADINE","10 MG","30","Select","Select",""],["","13668000705","ZOLPIDEM TARTRATE","5 MG","30","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":""}]}]}