{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DENNIS ROBINSON","gend":0,"add":"PO BOX 605","city":"SAINT PAUL","state":"VA","zip":"24283-9998","dob":"1969-07-14","age":"","mstatus":"","insh":"2387505*01","cliId":"","pno":4434622646,"cno":4434622646,"email":"","ename":"","eno":"","pphy":"KEEL, TRENTON W DO","ppno":2767622300,"pcpadd":"16431 WISE ST,","pcpcity":"SAINT PAUL","pcpstate":"VA","pcpzip":"24283-9998","pcpcounty":"","pcpid":"","pcpname":"Bhrha-A Department Of Russel County Hospital","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2767620612,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I11.0","NO DATA","J96.10","I50.33","R36.9","R19.00","F17.210","E66.01","Z68.37","E11.65","Z79.01","Z79.899","R60.9","R60.1","I50.43","J96.21","R57.0","I13.0","J91.8","R18.8","K56.7","E11.22","E66.9","R63.4","I42.0","Z79.84","J96.00","I48.91","I44.1","N17.9","J90.","K56.609","J98.11","I50.21","R74.01","G47.33","R06.83","R06.81","I50.42","I15.9","Z01.818","Z20.822","S61.411A","S61.441A","I82.621","Z23.","F32.1","F15.20","F43.22","S06.5X0A","S06.6X0A","S02.2XXA","J96.90","S06.5XAA","G93.40","S02.40EA","G81.91","I25.10","I10.","E11.9","G40.909","B95.62","Z48.811","S06.5XAD","J15.212","I48.3","S06.6XAD","E78.5","I07.1","I48.0","J01.10","K76.9","V54.19","S06.6XAA","I48.20","I50.40","J96.01","I50.82","N18.9","K92.9","S02.31XA","Y04.8XXA","A49.02","Y09.","I48.19","R07.89","R06.02","I42.9","R73.9","R42.","I08.1","R93.1","I50.31","I45.10","I71.2","S02.402A","R53.82","J30.2","G62.9","Z68.41","E11.00","F17.200","I44.0","I45.4","I45.9","I47.1","V58.89","I69.011","R14.0","F17.221","I25.82","I25.5","S99.921A","Z13.31","I48.11"],"date":["2023-04-18","2023-04-18","2021-05-18","2021-05-17","2021-05-17","2021-05-17","2023-04-07","2021-05-17","2021-05-17","2023-07-24","2023-04-17","2023-04-18","2021-05-17","2022-04-19","2021-06-29","2021-06-29","2021-07-05","2021-07-05","2021-06-29","2023-04-18","2021-07-01","2021-06-29","2021-06-29","2021-06-29","2021-12-09","2021-06-29","2021-07-01","2023-07-24","2021-07-01","2021-07-05","2021-07-05","2021-07-01","2021-07-01","2021-07-01","2021-07-05","2023-04-18","2021-09-17","2021-07-06","2023-07-24","2022-04-19","2021-12-13","2021-12-13","2022-07-22","2022-07-22","2022-07-22","2022-07-22","2022-11-17","2022-11-17","2022-11-17","2023-04-15","2023-04-15","2023-04-17","2023-04-01","2023-07-24","2023-04-01","2023-04-13","2023-04-17","2023-04-17","2023-04-17","2023-04-17","2023-04-17","2023-04-17","2023-04-13","2023-04-18","2023-04-18","2023-04-18","2023-04-18","2023-04-18","2023-04-18","2023-08-09","2023-04-18","2023-04-18","2023-04-18","2023-04-18","2021-07-05","2023-04-25","2021-07-05","2021-07-15","2021-07-05","2021-07-05","2023-04-10","2023-03-24","2023-04-10","2023-04-10","2021-07-15","2021-06-29","2021-12-07","2021-06-29","2022-02-15","2021-06-29","2021-07-01","2021-07-01","2021-05-19","2021-05-19","2021-05-26","2023-04-17","2023-07-24","2023-07-24","2023-07-24","2023-07-24","2021-08-23","2021-06-30","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2023-08-08","2023-08-08","2021-05-06","2021-06-30","2021-08-16","2021-08-16","2022-04-19","2022-04-19","2021-06-29"],"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":[["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","55111032205","GLIMEPIRIDE","4 MG","60","Select","Select",""],["","51862024030","AMIODARONE","TAB 100MG","30","Select","Select",""],["","00003089421","ELIQUIS","5 MG","60","Select","Select",""],["","69315011710","FUROSEMIDE","40 MG","60","Select","Select",""],["","68382009501","CARVEDILOL","25 MG","120","Select","Select",""],["","00310621030","FARXIGA","10 MG","30","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","00185067405","HYDROXYZ PAM","CAP 25MG","66","Select","Select",""],["","23155002401","BUSPIRONE","TAB 10MG","44","Select","Select",""],["","43547028110","ESCITALOPRAM","TAB 10MG","22","Select","Select",""],["","24208091055","ERYTHROMYCIN","5 MG\/GRAM","7","Select","Select",""],["","62332063831","DOXEPIN HCL","25 MG","30","Select","Select",""],["","00002150680","MOUNJARO","2.5 MG\/0.5","2","Select","Select",""],["","00185067405","HYDROXYZINE PAMOATE","25 MG","30","Select","Select",""],["","42806054701","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","55111078401","FEXOFENADINE HCL","180 MG","11","Select","Select",""],["","08290309581","LUER-LOK SYRINGE-NEEDLE","25GX1\"","1","Select","Select",""],["","31722053705","LEVETIRACETAM","500 MG","60","Select","Select",""],["","69680011225","CYANOCOBALAMIN INJECTION","1000MCG\/ML","1","Select","Select",""],["","23155002405","BUSPIRONE HCL","10 MG","60","Select","Select",""],["","69097012715","AMLODIPINE BESYLATE","5 MG","30","Select","Select",""],["","43547028111","ESCITALOPRAM OXALATE","10 MG","30","Select","Select",""],["","51862024030","AMIODARONE HCL","100 MG","30","Select","Select",""],["","43598044828","NICOTINE PATCH","21 MG\/24HR","28","Select","Select",""],["","00169406012","VICTOZA","2-PAK 0.6 MG\/0.1","6","Select","Select",""],["","08222095435","ULTICARE PEN NEEDLE","32GX 5\/32\"","90","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":""}]}]}