{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LATESHA JONES","gend":1,"add":"109 WEST END BLVD","city":"EMPORIA","state":"VA","zip":"23847-9998","dob":"1972-07-18","age":"","mstatus":"","insh":"2129052*01","cliId":"","pno":3475600243,"cno":3475600243,"email":"","ename":"","eno":"","pphy":"BYERS, KELLY NP","ppno":4346346101,"pcpadd":"6 DOCTORS DR,","pcpcity":"EMPORIA","pcpstate":"VA","pcpzip":"23847-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4346348611,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.81","F10.20","F43.10","S41.152A","S41.112A","F43.12","F41.1","L30.9","L29.8","L85.3","L98.8","L08.9","L70.0","L90.5","L81.0","N76.0","N95.1","Z68.37","M17.12","Z51.81","Z11.3","R07.89","F41.9","F43.0","J45.909","E66.09","Z68.31","Z13.6","Z83.3","M17.11","F43.23","Z01.419","Z12.39","F10.10"],"date":["2022-06-14","2023-04-25","2022-06-14","2022-07-15","2022-07-15","2022-08-02","2023-04-25","2022-05-18","2022-05-18","2022-05-18","2022-05-18","2022-05-18","2022-05-18","2022-05-18","2022-05-18","2023-01-10","2023-01-10","2023-02-17","2023-03-01","2022-05-09","2023-02-17","2021-03-19","2021-03-19","2021-03-19","2021-03-19","2021-03-19","2021-03-19","2021-03-19","2021-03-19","2022-12-20","2021-08-03","2021-09-20","2021-09-20","2023-01-31"],"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":[["","43547028111","ESCITALOPRAM","TAB 10MG","90","Select","Select",""],["","00172392760","DIAZEPAM","10 MG","15","Select","Select",""],["","42192015101","HYDROQUINONE","CRE 0.04","28","Select","Select",""],["","60505476505","APO-VARENICL","TAB 0.5MG","11","Select","Select",""],["","43547028950","BUPROPION","TAB 150MG SR","180","Select","Select",""],["","68645056354","IBUPROFEN","800 MG","90","Select","Select",""],["","29300041519","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","00574220545","TRETINOIN","CRE 0.0005","45","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","75","Select","Select",""],["","63304061650","DOXYCYC MONO","CAP 100MG","20","Select","Select",""],["","00168004046","BETAMETH VAL","CRE 0.001","45","Select","Select",""],["","55111028130","LEVOFLOXACIN","TAB 750MG","7","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","90","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","43547028111","ESCITALOPRAM OXALATE","10 MG","90","Select","Select",""],["","43547028950","BUPROPION HCL SR","150 MG","60","Select","Select",""],["","50111056003","TRAZODONE HCL","50 MG","90","Select","Select",""],["","45802013970","METRONIDAZOLE","0.75 %","70","Select","Select",""],["","63304061650","DOXYCYCLINE MONOHYDRATE","100 MG","28","Select","Select",""],["","43547028111","ESCITALOPRAM TAB","10MG","90","Select","Select",""],["","00172392760","DIAZEPAM TAB","10MG","15","Select","Select",""],["","60505476606","APO-VARENICL TAB","1MG","60","Select","Select",""],["","42192015101","HYDROQUINONE CRE","4%","28","Select","Select",""],["","43547028950","BUPROPION TAB","150MG SR","180","Select","Select",""],["","29300041519","CYCLOBENZAPR TAB","10MG","30","Select","Select",""],["","68645056354","IBUPROFEN TAB","800MG","90","Select","Select",""],["","00574220545","TRETINOIN CRE","0.05%","45","Select","Select",""],["","00168004046","BETAMETH VAL CRE","0.1%","45","Select","Select",""],["","50111056001","TRAZODONE TAB","50MG","90","Select","Select",""],["","31722099601","HYDROCO\/APAP TAB","5-325MG","12","Select","Select",""],["","60432060416","PROMETHAZINE SYP DM","","150","Select","Select",""],["","63304061650","DOXYCYC MONO CAP","100MG","20","Select","Select",""],["","55111028130","LEVOFLOXACIN TAB","750MG","7","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":""}]}]}