{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PAMELA A WOLFORD","gend":1,"add":"11304 SETZER ROAD","city":"STONY CREEK","state":"VA","zip":"23882-9998","dob":"1963-10-19","age":"","mstatus":"","insh":"2159647*01","cliId":"","pno":4342466012,"cno":4342466012,"email":"","ename":"","eno":"","pphy":"MATHERLEE, MICHAEL D MD","ppno":4342466100,"pcpadd":"12454 HARTLEY ST,","pcpcity":"STONY CREEK","pcpstate":"VA","pcpzip":"23882-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4342466614,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z01.818","C55.","R06.2","F17.210","C54.1","Z01.419","N95.0","Z12.72","Z92.29","R32.","E66.9","J01.90","NO DATA","J18.9","N94.6","E78.00","M19.90","G47.00","N95.1","Z90.710","U07.1","N64.9","R93.89","R93.5","R60.0","R09.82","H25.13","H04.123","H66.91","R21.","M62.838","Z23.","R05.1","R20.2","G43.019","M54.5","F32.9","F41.9","Z68.41","Z04.9"],"date":["2021-08-02","2021-08-02","2021-08-02","2021-09-03","2022-03-17","2021-05-18","2021-07-15","2021-05-18","2021-05-18","2022-03-17","2022-03-17","2022-08-12","2022-10-07","2023-01-09","2021-06-08","2021-06-08","2021-06-15","2021-10-07","2021-09-03","2021-09-03","2022-07-21","2021-07-07","2021-07-07","2021-07-07","2021-10-07","2022-08-12","2023-03-23","2023-03-23","2021-03-04","2021-08-06","2022-09-15","2022-10-14","2022-10-27","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-07-22"],"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":[["","64380080707","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","16714047801","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","80777027399","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","65862014836","SUMATRIPTAN","TAB 100MG","12","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","59762444002","METHYLPRED","TAB 4MG","21","Select","Select",""],["","45963055650","GABAPENTIN","300 MG","90","Select","Select",""],["","68382080605","TRAZODONE","TAB 100MG","30","Select","Select",""],["","57896045101","GERI-KOT","TAB 8.6MG","30","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","00904672559","SENNA","TAB 8.6MG","30","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","59762040105","SUCRALFATE","TAB 1GM","60","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","5","Select","Select",""],["","69315015510","HYDROCHLOROT","TAB 12.5MG","30","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","60","Select","Select",""],["","58160089052","FLUARIX QUAD","INJ 2022-23","0","Select","Select",""],["","00054981729","PREDNISONE","TAB 10MG","27","Select","Select",""],["","71093014105","METHOCARBAM","TAB 750MG","30","Select","Select",""],["","69315015510","HYDROCHLOROTHIAZIDE","12.5 MG","30","Select","Select",""],["","59762444002","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","65862019105","CYCLOBENZAPRINE HCL","10 MG","60","Select","Select",""],["","68180071160","CEFDINIR","300 MG","20","Select","Select",""],["","00781286810","OMEPRAZOLE","20 MG","30","Select","Select",""],["","43386009019","GAVILYTE-G","236-22.74G","4000","Select","Select",""],["","68382005101","MELOXICAM","15 MG","30","Select","Select",""],["","69315015510","HYDROCHLOROT TAB","12.5MG","30","Select","Select",""],["","00781261305","AMOXICILLIN CAP","500MG","30","Select","Select",""],["","52817033200","CYCLOBENZAPR TAB","10MG","60","Select","Select",""],["","59762444002","METHYLPRED TAB","4MG","21","Select","Select",""],["","00093317431","ALBUTEROL AER HFA","","8","Select","Select",""],["","00054981729","PREDNISONE TAB","10MG","27","Select","Select",""],["","71093014105","METHOCARBAM TAB","750MG","30","Select","Select",""],["","58160089052","FLUARIX QUAD INJ","2022-23","0","Select","Select",""],["","71093012105","GABAPENTIN CAP","300MG","90","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":""}]}]}