{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HANNAH THORNTON","gend":1,"add":"19706 ALBERT DR","city":"DINWIDDIE","state":"VA","zip":"23841-9998","dob":"1984-02-01","age":"","mstatus":"","insh":"2192958*01","cliId":"","pno":8042622491,"cno":8042622491,"email":"","ename":"","eno":"","pphy":"RUSSELL, AMANDA MD","ppno":8044693731,"pcpadd":"13855 COURTHOUSE ROAD","pcpcity":"DINWIDDIE","pcpstate":"VA","pcpzip":"23841-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8044695307,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["A52.3","S69.91XA","NO DATA","V62.84","Z20.822","F10.10","Z03.818","F32.9","F10.20","K70.10","F33.3","F33.1","S59.911A","X78.9XXA","F12.90","F12.20","F31.30","S69.80XA","K70.30","F17.200","Z68.25","E66.3","F31.5","F14.10","F25.9","A52.8","K46.9","E66.9","S60.021A","F41.1","Z71.1","F17.210","K74.60","Z79.1","Z79.52","Z79.899","Z88.2","Z87.440","Z20.2","F29.","K70.31","Z09.","Z68.22","F32.1","F10.229","F41.9","F51.5","F10.929","A53.9","S66.821A","Z76.0","R19.8","Z87.898","Z87.891","R06.02","R63.0","Z32.02"],"date":["2021-10-19","2022-05-24","2022-08-18","2023-01-29","2022-08-18","2022-12-22","2022-12-22","2022-12-23","2023-03-27","2022-12-23","2023-01-04","2022-12-26","2022-02-26","2022-02-28","2022-02-28","2022-03-10","2022-05-04","2022-05-04","2022-05-04","2022-11-27","2022-05-04","2022-05-04","2023-01-10","2023-01-10","2023-03-27","2021-09-26","2022-03-19","2022-03-19","2022-11-27","2023-01-29","2021-09-07","2021-09-20","2021-09-07","2021-09-07","2021-09-07","2022-04-13","2022-04-13","2021-09-07","2021-09-07","2022-03-22","2021-10-19","2021-10-19","2021-10-19","2021-09-20","2021-09-20","2021-09-20","2021-09-20","2021-09-20","2021-09-20","2022-05-24","2022-06-24","2022-04-13","2022-04-13","2022-04-13","2022-04-13","2022-06-24","2023-03-14"],"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":[["","50111056101","TRAZODONE","TAB 100MG","2","Select","Select",""],["","43547028110","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","33342006707","OLANZAPINE","2.5 MG","30","Select","Select",""],["","00054429731","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","00536247085","MILK OF MAGN","SUS ","473","Select","Select",""],["","47469016068","MELATONIN","3 MG","30","Select","Select",""],["","00093314505","CEPHALEXIN","CAP 250MG","21","Select","Select",""],["","00536589688","NICOTINE TD","DIS 21MG\/24H","14","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","14539067501","HYDROXYZ PAM","CAP 50MG","30","Select","Select",""],["","00536340501","NICOTINE POL","GUM 4MG","100","Select","Select",""],["","00378210001","LOPERAMIDE","CAP 2MG","30","Select","Select",""],["","00363017508","PAIN RELIEVE","TAB 500MG","30","Select","Select",""],["","63402030230","LATUDA","20 MG","30","Select","Select",""],["","00093083205","CLONAZEPAM","TAB 0.5MG","30","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","42","Select","Select",""],["","00115180301","HYDROXYZINE PAMOATE","25 MG","60","Select","Select",""],["","69097084805","ESCITALOPRAM OXALATE","10 MG","30","Select","Select",""],["","72205020730","LURASIDONE HCL","20 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":""}]}]}