{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AMANDA L LESTER","gend":1,"add":"102 SUTHERLAND RD APT 46D","city":"GALAX","state":"VA","zip":"24333-9998","dob":"1981-02-22","age":"","mstatus":"","insh":"2386964*01","cliId":"","pno":4233889399,"cno":4233889399,"email":"","ename":"","eno":"","pphy":"HELM, DIANE K NP","ppno":2762380439,"pcpadd":"961 E STUART DR,","pcpcity":"GALAX","pcpstate":"VA","pcpzip":"24333-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2762380404,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I72.0","R90.82","I77.3","I72.8","R07.2","I21.4","F41.9","F43.10","F40.01","I25.42","I25.2","Z87.898","Z86.010","NO DATA","I25.10","E88.81","Z86.79","E66.9","J06.9","R05.9","R06.89","I24.9","R07.89","R07.9","Z20.822","I10.","F39.","F43.12","Z72.0","R63.5","Z09.","R06.02","R00.2","N10.","I77.71","F41.8","F41.0","E66.3","F12.90","F17.210","F40.10","I20.9","F32.9","Z82.49","Z79.82","Z68.29","J02.0","S00.411A","B95.0","Z87.891","X58.XXXA","I67.1","U07.1","J01.00"],"date":["2023-03-10","2022-08-15","2023-07-20","2023-07-20","2021-09-29","2021-09-30","2023-02-02","2021-11-18","2021-11-18","2023-05-15","2023-05-15","2021-11-18","2021-11-18","2021-11-18","2023-05-08","2022-04-15","2023-03-03","2023-07-28","2023-09-10","2023-09-10","2023-09-10","2021-09-29","2021-09-29","2021-09-30","2023-02-02","2022-11-09","2021-07-20","2021-07-20","2022-07-14","2023-05-08","2023-07-28","2021-09-29","2022-05-19","2022-07-06","2023-03-10","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2023-02-02","2023-02-02","2023-02-02","2023-09-19","2023-02-02","2022-06-21","2022-12-10","2023-09-19"],"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":[["","00904678370","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","68462016405","CARVEDILOL","12.5 MG","32","Select","Select",""],["","57237000299","HYDROCHLOROT","CAP 12.5MG","30","Select","Select",""],["","55111019605","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","69367016204","PHENAZOPYRID","TAB 100MG","6","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","00363041414","ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","60846050101","PYRIDIUM","TAB 100MG","6","Select","Select",""],["","43547036011","LOSARTAN POT","TAB 25MG","30","Select","Select",""],["","43547035211","LISINOPRIL","5 MG","30","Select","Select",""],["","00169452514","WEGOVY","0.25MG\/0.5","2","Select","Select",""],["","00363056314","ASPIRIN EC","81 MG","25","Select","Select",""],["","68462015713","ONDANSETRON ODT","4 MG","10","Select","Select",""],["","65862017760","CEFDINIR","300 MG","20","Select","Select",""],["","00169418113","OZEMPIC .","25 OR 0.5","3","Select","Select",""],["","50383002510","OFLOXACIN","0.3 %","10","Select","Select",""],["","45802011214","MUPIROCIN","2 %","30","Select","Select",""],["","65862050320","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":""}]}]}