{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN B SIMMONS","gend":0,"add":"208 HUNGRY HOLLOW ROAD","city":"BLAND","state":"VA","zip":"24315-9998","dob":"1972-08-29","age":"","mstatus":"","insh":"2177424*01","cliId":"","pno":2766884478,"cno":2766884478,"email":"","ename":"","eno":"","pphy":"TURSKI, JOHN T DO","ppno":2766884331,"pcpadd":"12301 GRAPEFIELD ROAD,","pcpcity":"BASTIAN","pcpstate":"VA","pcpzip":"24314-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2766884336,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","E11.9","E78.2","E11.319","I25.10","K21.9","H25.011","H52.12","H52.221","H52.4","L03.319","I50.30","Z87.891","K76.0","Z95.5","I25.2","N18.2","Z12.5","Z71.3","Z71.82","Z68.30","Z68.33","R07.2","R61.","E11.22","I12.9","NO DATA","E78.5","G47.30","Z79.84","Z79.02","Z79.82","R07.89","R58.","T81.9XXA","L02.214","R10.32","K52.9","Z20.822","R10.13","D72.829","K82.4","Z12.11","R10.11","R11.0","R06.02","R94.31","I51.7","R21.","L76.21","L76.31","L02.211","R10.826","R19.7","R74.8","I44.0","Z79.899","J22.","I45.19","L03.311","L30.8","Z68.31","R10.84","E86.0","R53.83","E87.6","H43.393"],"date":["2023-05-02","2023-06-16","2022-11-30","2021-05-27","2022-11-30","2021-05-27","2023-06-16","2022-06-14","2022-06-14","2022-06-14","2021-11-30","2022-05-03","2022-08-16","2022-11-30","2022-11-30","2022-11-30","2022-11-30","2022-11-30","2022-11-30","2022-11-30","2022-11-30","2021-02-04","2021-09-19","2021-09-19","2022-08-16","2022-08-16","2022-08-16","2022-08-16","2021-09-19","2022-08-16","2022-08-16","2022-08-16","2021-09-19","2021-12-01","2021-12-01","2021-12-01","2021-12-12","2021-12-12","2021-12-12","2022-08-16","2022-03-28","2022-04-20","2022-04-20","2022-08-16","2022-08-16","2022-08-16","2022-08-16","2021-09-19","2021-09-30","2021-12-01","2021-12-01","2021-12-01","2022-03-30","2022-03-30","2022-08-16","2022-08-16","2022-08-16","2022-08-18","2021-10-20","2021-12-01","2022-01-25","2022-01-25","2022-03-28","2022-03-28","2022-03-28","2022-03-28","2023-06-16"],"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":[["","65862035705","CLOPIDOGREL","75 MG","30","Select","Select",""],["","67877069601","CHLORTHALID","TAB 25MG","30","Select","Select",""],["","51672129701","CLOBETASOL E","CRE 0.0005","15","Select","Select",""],["","31722059690","FENOFIBRATE","145 MG","90","Select","Select",""],["","68382009505","CARVEDILOL","25 MG","180","Select","Select",""],["","00193731025","CONTOUR","TES NEXT","25","Select","Select",""],["","00006027731","JANUVIA","100 MG","90","Select","Select",""],["","43547036109","LOSARTAN POT","TAB 50MG","60","Select","Select",""],["","70010006310","METFORMIN","TAB 500MG","60","Select","Select",""],["","60505267109","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","50742026001","NIFEDIPINE","TAB 30MG ER","90","Select","Select",""],["","68462039610","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","70710168400","FAMOTIDINE","40 MG","90","Select","Select",""],["","00310621030","FARXIGA","10 MG","90","Select","Select",""],["","00832532511","POT CL MICRO","TAB 20MEQ ER","3","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","68382004101","PROMETHAZINE","TAB 25MG","20","Select","Select",""],["","65862055990","PANTOPRAZOLE","TAB 20MG","30","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","46122041660","GNP MUCUS ER","TAB 600MG","20","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","68682010510","NIFEDIPINE ER","30 MG","30","Select","Select",""],["","68645058459","METFORMIN HCL","1000 MG","180","Select","Select",""],["","31722070190","LOSARTAN POTASSIUM","50 MG","180","Select","Select",""],["","67877069601","CHLORTHALIDONE","25 MG","90","Select","Select",""],["","00093505798","ATORVASTATIN CALCIUM","80 MG","90","Select","Select",""],["","65162063609","PANTOPRAZOLE SODIUM","20 MG","90","Select","Select",""],["","65862035705","CLOPIDOGREL TAB","75MG","30","Select","Select",""],["","00378022201","CHLORTHALID TAB","25MG","30","Select","Select",""],["","51672129703","CLOBETASOL E CRE","0.05%","60","Select","Select",""],["","00006027754","JANUVIA TAB","100MG","90","Select","Select",""],["","68001015200","CARVEDILOL TAB","25MG","60","Select","Select",""],["","00193731025","CONTOUR TES NEXT","","25","Select","Select",""],["","43547036109","LOSARTAN POT TAB","50MG","60","Select","Select",""],["","60505267109","ATORVASTATIN TAB","80MG","90","Select","Select",""],["","50742026001","NIFEDIPINE TAB","30MG ER","90","Select","Select",""],["","70010006305","METFORMIN TAB","500MG","180","Select","Select",""],["","00378306605","FENOFIBRATE TAB","145MG","90","Select","Select",""],["","00093314705","CEPHALEXIN CAP","500MG","30","Select","Select",""],["","00310621030","FARXIGA TAB","10MG","90","Select","Select",""],["","65862055990","PANTOPRAZOLE TAB","20MG","30","Select","Select",""],["","72606051002","FAMOTIDINE TAB","40MG","30","Select","Select",""],["","68462039610","OMEPRAZOLE CAP","20MG","30","Select","Select",""],["","68462015713","ONDANSETRON TAB","4MG ODT","10","Select","Select",""],["","68382004101","PROMETHAZINE TAB","25MG","20","Select","Select",""],["","00832532511","POT CL MICRO TAB","20MEQ ER","3","Select","Select",""],["","65862001501","AMOXICILLIN TAB","875MG","20","Select","Select",""],["","46122041660","GNP MUCUS ER TAB","600MG","20","Select","Select",""],["","68180096301","ALBUTEROL AER HFA","","8","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":""}]}]}