{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHRISTINA L HENSLEY","gend":1,"add":"957 TURKEY KNOB ROAD","city":"QUICKSBURG","state":"VA","zip":"22847-9998","dob":"1970-11-22","age":"","mstatus":"","insh":"2473673*01","cliId":"","pno":5403337035,"cno":5403337035,"email":"","ename":"","eno":"","pphy":"LOVELACE, NANCE DO","ppno":5404591340,"pcpadd":"9166 NORTH CONGRESS ST,","pcpcity":"NEW MARKET","pcpstate":"VA","pcpzip":"22844-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5404591349,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","N08.","C90.00","D64.9","D03.62","I12.9","N18.9","G89.29","M54.9","Z23.","D48.5","D17.23","D17.24","L72.0","L90.5","D22.61","L57.8","L81.4","L82.1","L85.3","Z08.","Z85.820","N18.6","D63.1","D63.0","Z79.899","C90.01","N29.","Z48.817","Z45.2","Z51.11","N18.4","N05.9","R10.9","Z86.2","Z86.006","Z68.41","D22.5","L81.0","L57.0","NO DATA","Z99.2","Z76.82","C43.62","N28.9","Z86.008","Z79.620","Z29.8","C88.8","M89.9","R77.8","R79.89","L71.8","L98.8","Z09.","Z87.2","E55.9","M72.2","Z51.12","M71.871","M79.671","N05.8"],"date":["2023-06-06","2023-02-21","2023-09-06","2022-12-21","2022-12-21","2023-08-09","2023-08-09","2023-06-15","2023-06-15","2022-12-21","2022-10-28","2022-10-28","2022-10-28","2023-05-01","2022-10-28","2022-10-28","2023-05-01","2022-10-28","2023-05-01","2023-05-01","2023-05-01","2023-05-01","2022-04-15","2023-06-15","2022-10-26","2023-08-09","2023-06-06","2022-05-04","2022-05-06","2022-05-31","2022-06-24","2023-06-06","2023-08-09","2023-06-15","2023-08-09","2023-08-09","2023-02-16","2023-05-01","2022-07-29","2022-07-29","2022-08-25","2022-04-05","2022-07-18","2022-04-22","2022-09-28","2022-09-28","2023-05-17","2022-10-26","2022-05-27","2022-07-14","2022-07-14","2023-06-15","2023-05-01","2023-05-01","2023-05-01","2023-05-01","2023-06-06","2023-07-26","2023-05-17","2023-07-26","2023-07-26","2023-05-30"],"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":[["","00054429931","FUROSEMIDE","40 MG","30","Select","Select",""],["","31722077701","ACYCLOVIR","400 MG","90","Select","Select",""],["","57664050658","METOPROL TAR","TAB 25MG","60","Select","Select",""],["","13811052501","TRIPHROCAPS","1 MG","30","Select","Select",""],["","42806054701","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","43547028111","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","68382056510","METOPROL SUC","TAB 50MG ER","30","Select","Select",""],["","00135011883","TUMS ULTRA","CHW 1000MG","30","Select","Select",""],["","68645051554","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","68382056510","METOPROLOL SUCCINATE","50 MG","30","Select","Select",""],["","31722052001","HYDRALAZINE HCL","25 MG","120","Select","Select",""],["","49035010313",""," ","72","Select","Select",""],["","31722077701","ACYCLOVIR TAB","400MG","30","Select","Select",""],["","13811052501","TRIPHROCAPS CAP","","30","Select","Select",""],["","42806054701","VITAMIN D CAP","1.25MG","4","Select","Select",""],["","43547040211","FUROSEMIDE TAB","40MG","30","Select","Select",""],["","57664050658","METOPROL TAR TAB","25MG","60","Select","Select",""],["","43547028111","ESCITALOPRAM TAB","10MG","30","Select","Select",""],["","00135011883","TUMS ULTRA CHW","1000MG","30","Select","Select",""],["","68382056510","METOPROL SUC TAB","50MG ER","30","Select","Select",""],["","68645051554","AMLODIPINE TAB","5MG","30","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4 MG","21","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":""}]}]}