{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHELBY L KING","gend":1,"add":"67 TUCKER LN APT B","city":"BOYDTON","state":"VA","zip":"23917-9998","dob":"2000-07-28","age":"","mstatus":"","insh":"2352884*01","cliId":"","pno":4342472879,"cno":4342472879,"email":"","ename":"","eno":"","pphy":"MCDONALD, KELLY MD","ppno":4345842273,"pcpadd":"1755 N MECKLENBURG AVE,","pcpcity":"SOUTH HILL","pcpstate":"VA","pcpzip":"23970-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4345845509,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z76.89","R11.2","Z01.411","N92.0","F41.9","E66.9","R03.0","Z68.37","Z11.3","N39.0","R19.7","Z88.1","H90.3","J02.9","B00.9","N91.2","Z32.01","E66.8","NO DATA","Z68.41","O99.612","K59.00","O23.12","N30.90","O26.892","R10.30","Z3A.17","Z87.891","N30.01","Z00.00","I10.","E11.9","E78.00","E66.01","F17.200","H66.93","R42.","M26.609","F45.8","R06.83","R40.0","Z20.822","R10.33","I12.0","N18.6","N17.9","N73.9","R10.31","R10.32","K42.9","O23.41","O99.891","Z3A.08","K21.9","Z90.49","H04.123","H52.13","S80.02XA","M25.562","L03.031","M79.674","M79.89","R10.11","K80.10","H66.90","R11.0","Z23.","R10.13","N20.0","Z68.38","R05.9","U07.1","S86.812A","K52.9","R94.5","J20.9","R51.9","O99.619","F03.90","O16.9","R00.2","Z68.39","S09.90XA","H92.03","B34.9","J06.9","R11.10","J09.X2","O24.419","Z71.9","K81.9","R10.10","Z3A.00","Z3A.36","V23.9","O24.415","Z34.80","O24.425","O99.214","O69.2XX0","Z3A.38","Z37.0","Z79.899","Z34.93","R09.81","R49.0","E16.2","D50.8","O16.4","F17.290","F17.210","R20.0","K92.1","R53.1","R10.12","F31.5","R13.10","R60.0","R13.19","R63.4","F31.9","F39.","E87.6","R07.89","F29.","G47.30","Z80.0","Z87.59","Z87.19","R45.89","Y90.0","F31.81","F42.2","F12.21","R07.9","M43.12","R91.8","R93.89"],"date":["2022-11-04","2023-07-27","2021-08-10","2021-08-10","2023-09-06","2023-08-30","2021-12-08","2023-08-30","2021-08-10","2022-10-01","2023-07-21","2021-10-30","2021-11-15","2022-04-04","2022-01-18","2022-10-03","2022-10-03","2023-04-25","2023-08-11","2023-09-06","2022-12-12","2022-12-12","2022-12-12","2022-12-12","2022-12-12","2022-12-12","2022-12-12","2023-07-21","2023-01-07","2021-09-02","2023-09-06","2021-10-15","2021-11-05","2023-09-06","2023-08-21","2021-10-11","2023-07-27","2021-10-26","2021-10-26","2021-10-26","2021-10-26","2023-09-04","2021-11-05","2021-11-05","2021-11-05","2021-11-05","2022-06-08","2022-06-08","2022-06-08","2022-06-08","2022-10-01","2022-10-01","2022-10-01","2023-09-06","2021-10-15","2021-10-20","2021-10-20","2022-07-13","2022-08-01","2022-11-30","2022-11-30","2023-08-30","2023-07-27","2021-04-27","2021-10-11","2021-10-11","2023-03-13","2021-04-20","2021-04-20","2022-11-04","2022-11-04","2022-01-04","2022-07-09","2021-04-09","2021-04-09","2022-11-04","2023-07-27","2021-10-04","2021-10-04","2021-10-04","2023-08-16","2021-12-13","2021-10-11","2021-10-11","2022-02-23","2022-04-04","2022-02-23","2022-02-23","2023-05-05","2022-10-11","2021-04-25","2023-07-27","2023-05-05","2023-04-25","2023-04-25","2023-04-10","2023-04-25","2023-05-10","2023-05-10","2023-05-10","2023-05-10","2023-05-10","2023-08-23","2023-05-10","2022-04-04","2022-04-04","2023-06-27","2023-06-27","2023-07-14","2023-09-06","2023-07-14","2023-07-06","2023-07-27","2023-07-27","2023-07-27","2023-09-05","2023-09-06","2023-08-30","2023-09-06","2023-07-21","2023-09-06","2023-08-22","2023-08-23","2023-08-16","2023-09-04","2023-09-06","2023-09-06","2023-09-06","2023-09-06","2023-08-02","2023-08-01","2023-08-23","2023-08-21","2023-08-21","2023-08-16","2023-08-23","2023-08-23","2023-08-23"],"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":[["","16714017001","BUT\/APAP\/CAF","CAP ","15","Select","Select",""],["","00555902858","JUNEL FE","TAB 1.5\/30","28","Select","Select",""],["","68645052254","SERTRALINE","TAB 50MG","30","Select","Select",""],["","64380078706","BUSPIRONE","TAB 7.5MG","60","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","69543038810","KETOROLAC","TAB 10MG","20","Select","Select",""],["","55111064530","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","20","Select","Select",""],["","29033000305","SUCRALFATE","TAB 1GM","28","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","20","Select","Select",""],["","62332002331","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","42135010000","COMPACT SPAC","MIS CHAMBER","1","Select","Select",""],["","68645055254","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","00093083201","CLONAZEPAM","TAB 0.5MG","15","Select","Select",""],["","16714008210","HYDROXYZ HCL","TAB 25MG","30","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00904505359","SUDOGEST","TAB 30MG","12","Select","Select",""],["","69238110002","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","63304061650","DOXYCYC MONO","CAP 100MG","20","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59746012106","MECLIZINE","TAB 25MG","12","Select","Select",""],["","68645059459","FAMOTIDINE","20 MG","30","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","31722077701","ACYCLOVIR","TAB 400MG","21","Select","Select",""],["","00069417034","ZMAX","SUS 2GM","1","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","5","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA","100","Select","Select",""],["","72647033104","METHYLPRED","TAB 4MG","21","Select","Select",""],["","53885001110","ONETOUCH DEL","MIS PLUS 30G","100","Select","Select",""],["","67877041301","METFORMIN","TAB 500MG ER","60","Select","Select",""],["","68382004101","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","00904505860","BISCOLAX","SUP 10MG","7","Select","Select",""],["","00527512570","LACTULOSE","SOL 10GM\/15","210","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","53885001110","ONETOUCH DELICA PLUS LANCET","30 GAUGE","100","Select","Select",""],["","53885024510","ONETOUCH ULTRA TEST STRIP","","50","Select","Select",""],["","60258018501","POLY-IRON","150 MG","30","Select","Select",""],["","62332002331","FLUOXETINE HCL","20 MG","30","Select","Select",""],["","67877041301","METFORMIN HCL ER","500 MG","60","Select","Select",""],["","55111015330","ONDANSETRON HCL","4 MG","30","Select","Select",""],["","65162047810","NITROFURANTOIN MONO-MACRO","100 MG","10","Select","Select",""],["","68645056259","IBUPROFEN","600 MG","30","Select","Select",""],["","68645059459","FAMOTIDINE TAB","20MG","90","Select","Select",""],["","31722077701","ACYCLOVIR TAB","400MG","21","Select","Select",""],["","00069417034","ZMAX SUS","2GM","1","Select","Select",""],["","68645055254","LISINOPRIL TAB","10MG","30","Select","Select",""],["","62332002331","FLUOXETINE CAP","20MG","30","Select","Select",""],["","55111015330","ONDANSETRON TAB","4MG","30","Select","Select",""],["","59746017509","PREDNISONE TAB","20MG","5","Select","Select",""],["","50111078751","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","55111064530","OMEPRAZOLE CAP","40MG","30","Select","Select",""],["","53885001110","ONETOUCH DEL MIS PLUS","30G","100","Select","Select",""],["","53885004601","ONETOUCH KIT ULTRA","2","1","Select","Select",""],["","72647033104","METHYLPRED TAB","4MG","21","Select","Select",""],["","63304069301","CLINDAMYCIN CAP","300MG","21","Select","Select",""],["","53885024510","ONETOUCH TES ULTRA","","100","Select","Select",""],["","68382004101","PROMETHAZINE TAB","25MG","30","Select","Select",""],["","65162047810","NITROFURANTN CAP","100MG","10","Select","Select",""],["","00527512570","LACTULOSE SOL","10GM\/15","210","Select","Select",""],["","67877041301","METFORMIN TAB","500MG ER","60","Select","Select",""],["","00904505860","BISCOLAX SUP","10MG","7","Select","Select",""],["","31722071390","PANTOPRAZOLE SODIUM","40 MG","90","Select","Select",""],["","16714036504","ELINEST","0.3-0.03MG","28","Select","Select",""],["","69367020301","BUTALBITAL-ACETAMINOPHEN-CAFFE","50-325-40","12","Select","Select",""],["","10135074932","VITAMIN D","3 25 MCG","30","Select","Select",""],["","68682010510","NIFEDIPINE ER","30 MG","30","Select","Select",""],["","59746012106","MECLIZINE HCL","25 MG","21","Select","Select",""],["","23155072301","LABETALOL HCL","100 MG","60","Select","Select",""],["","29300011101","LAMOTRIGINE","25 MG","30","Select","Select",""],["","50228038160","QUETIAPINE FUMARATE ER","150 MG","30","Select","Select",""],["","16714008210","HYDROXYZINE HCL","25 MG","60","Select","Select",""],["","29300014001","DIVALPROEX SODIUM","500 MG","60","Select","Select",""],["","00832532511","POTASSIUM CHLORIDE","20 MEQ","10","Select","Select",""],["","13668021830","ARIPIPRAZOLE","10 MG","30","Select","Select",""],["","13668046530","LURASIDONE HCL","40 MG","30","Select","Select",""],["","00228282011","HYDROCHLOROTHIAZIDE","12.5 MG","90","Select","Select",""],["","65862007701","CIPROFLOXACIN HCL","500 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":""}]}]}