{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NAJWA  M TRAD","gend":1,"add":"129 NEWBERN RD APT 1","city":"DUBLIN","state":"VA","zip":"24084-9998","dob":"1981-08-27","age":"","mstatus":"","insh":"2130919*01","cliId":"","pno":5406413231,"cno":5406413231,"email":"","ename":"","eno":"","pphy":"FOUSE, DAWN N PA","ppno":5403811882,"pcpadd":"10 HICKOK ST STE 101,","pcpcity":"CHRISTIANSBURG","pcpstate":"VA","pcpzip":"24073-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5403821866,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.9","R19.7","R11.2","Z20.822","S91.201A","S99.921A","R68.84","F90.9","K04.7","G40.909","F17.200","K08.89","O03.4","O20.9","F32.9","M51.36","G56.01","Z13.220","K05.10","Z12.39","Z13.89","N93.9","R42.","R53.83","R68.83","O09.521","O03.9","O26.891","O99.331","Z3A.08","R10.2","K03.81","W20.8XXA","R10.32","R10.31","R06.02","R52.","O20.0"],"date":["2022-03-11","2022-03-11","2022-10-08","2022-03-11","2022-07-21","2022-07-21","2021-05-15","2022-02-02","2022-10-06","2022-10-06","2023-06-17","2022-10-06","2023-07-11","2023-07-11","2022-02-02","2022-02-02","2021-07-22","2021-07-22","2022-02-02","2022-02-02","2022-02-02","2022-03-11","2022-03-11","2022-03-11","2022-03-11","2023-06-17","2023-07-12","2023-06-17","2023-06-17","2023-06-17","2023-06-17","2022-07-07","2022-07-21","2023-07-11","2023-07-11","2022-10-08","2022-10-08","2023-06-17"],"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":[["","31722099601","HYDROCO\/APAP TAB","5-325MG","15","Select","Select",""],["","00527150237","AMPHET\/DEXTR TAB","10MG","60","Select","Select",""],["","51672404801","CLOTRIM\/BETA CRE DIPROP","","60","Select","Select",""],["","65862019405","FLUOXETINE CAP","40MG","90","Select","Select",""],["","00116200116","CHLORHEX GLU SOL","0.12%","473","Select","Select",""],["","68180012202","CEPHALEXIN CAP","500MG","42","Select","Select",""],["","65162019011","NAPROXEN TAB","500MG","20","Select","Select",""],["","00781261305","AMOXICILLIN CAP","500MG","30","Select","Select",""],["","50383077504","LIDOCAINE SOL","2% VISC","100","Select","Select",""],["","68382004101","PROMETHAZINE TAB","25MG","12","Select","Select",""],["","68382005005","MELOXICAM TAB","7.5MG","10","Select","Select",""],["","42858010201","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","12","Select","Select",""],["","10702001801","OXYCODONE HCL","5 MG","10","Select","Select",""],["","65162019011","NAPROXEN","500 MG","30","Select","Select",""],["","68462030529","NORETHINDRONE","0.35 MG","84","Select","Select",""],["","00093031401","KETOROLAC TROMETHAMINE","10 MG","15","Select","Select",""],["","68645056354","IBUPROFEN","800 MG","30","Select","Select",""],["","00781261305","AMOXICILLIN","500 MG","30","Select","Select",""],["","43386016106","MISOPROSTOL","200 MCG","4","Select","Select",""],["","68382004101","PROMETHAZINE HCL","25 MG","12","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","15","Select","Select",""],["","00527150237","AMPHET\/DEXTR","TAB 10MG","60","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","65862019405","FLUOXETINE","CAP 40MG","90","Select","Select",""],["","51672404801","CLOTRIM\/BETA","CRE DIPROP","60","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","42","Select","Select",""],["","50383077504","LIDOCAINE","SOL 2% VISC","100","Select","Select",""],["","68382004101","PROMETHAZINE","TAB 25MG","12","Select","Select",""],["","68382005005","MELOXICAM","TAB 7.5MG","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":""}]}]}