{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WILLIAM E WILLIAMS","gend":0,"add":"509 WARREN AVE","city":"FRONT ROYAL","state":"VA","zip":"22630-9998","dob":"1974-06-13","age":"","mstatus":"","insh":"2295505*01","cliId":"","pno":5403051064,"cno":5403051064,"email":"","ename":"","eno":"","pphy":"LAPLANTE, MARIA MD","ppno":5406350800,"pcpadd":"120 N COMMERCE AVENUE STE 203,","pcpcity":"FRONT ROYAL","pcpstate":"VA","pcpzip":"22630-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5406350801,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L70.2","C44.202","J32.0","J34.89","C44.222","J18.9","J44.1","I10.","K21.9","J84.9","Q24.0","F17.210","E78.5","Z20.822","I25.2","Z86.14","J43.9","Z79.82","Z79.899","Z82.49","Z86.16","Z82.5","Z82.3","Z83.3","J20.9","J42.","R09.81","R05.1","J18.1","R05.3","R91.8","J01.01","J44.9","L72.0","L82.1","Z85.828","J32.9","D48.9","L98.8","R06.02","R73.01","U07.1","R09.82","J41.1","J47.9","J11.1","J02.9","R11.2","R19.7","R06.09","R05.9"],"date":["2021-08-23","2021-08-23","2021-09-07","2021-09-07","2021-09-24","2022-03-30","2022-12-30","2022-12-11","2022-12-11","2022-03-26","2022-03-26","2022-03-26","2022-12-11","2022-12-30","2022-03-26","2022-03-26","2022-03-26","2022-03-26","2022-03-26","2022-03-26","2022-03-26","2022-03-26","2022-03-26","2022-03-26","2022-12-11","2022-12-11","2022-12-11","2022-12-11","2023-02-08","2023-02-08","2023-02-08","2021-03-22","2022-11-24","2022-09-29","2022-07-15","2022-07-15","2021-09-24","2021-08-23","2021-08-23","2022-11-24","2021-03-17","2021-03-17","2021-03-17","2021-06-11","2021-09-24","2022-03-26","2022-03-26","2022-03-26","2022-03-26","2022-03-30","2022-11-24"],"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":[["","13668008130","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","63304082890","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","69097017353","IPRATROPIUM\/","SOL ALBUTER","90","Select","Select",""],["","00536131108","CHEST CONGES","TAB 400MG","12","Select","Select",""],["","00310460012","BEVESPI","AER 9-4.8MCG","11","Select","Select",""],["","64380078408","PREDNISONE","10 MG","38","Select","Select",""],["","00574010770","CLOTRIMAZOLE","TRO 10MG","35","Select","Select",""],["","00173072020","FLOVENT HFA","220 MCG","12","Select","Select",""],["","00597015561","STIOLTO","AER 2.5-2.5","8","Select","Select",""],["","00781286810","OMEPRAZOLE","20 MG","90","Select","Select",""],["","69097012805","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","00597002402","COMBIVENT","AER 20-100","4","Select","Select",""],["","68001000501","METHYLPRED","TAB 4MG","21","Select","Select",""],["","68382070718","DOXYCYC MONO","CAP 100MG","20","Select","Select",""],["","58657050508","GG\/DM","SYP 100-10\/5","118","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","21","Select","Select",""],["","65862064130","AZITHROMYCIN","250 MG","12","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00093227534","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","50383080416","PROMETH\/COD","SYP 6.25-10","118","Select","Select",""],["","69097094505","ATORVASTATIN CALCIUM","20 MG","90","Select","Select",""],["","67877019905","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","00310460012","BEVESPI AEROSPHERE","9-4.8 MCG","10.7","Select","Select",""],["","66993008096","FLUTICASONE PROPIONATE HFA","220 MCG","12","Select","Select",""],["","13668008190","MONTELUKAST SODIUM","10 MG","90","Select","Select",""],["","55111028050","LEVOFLOXACIN","500 MG","7","Select","Select",""],["","65862017760","CEFDINIR","300 MG","28","Select","Select",""],["","69097084064","IPRATROPIUM-ALBUTEROL","0.5-3MG\/3","360","Select","Select",""],["","00093227534","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","20","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":""}]}]}