{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CARMEN MEJIA DE GONZALEZ","gend":1,"add":"1591 OLD INDIAN TRL","city":"MONETA","state":"VA","zip":"24121-9998","dob":"1957-08-30","age":"","mstatus":"","insh":"2476902*01","cliId":"","pno":4342000340,"cno":4342000340,"email":"","ename":"","eno":"","pphy":"SENTER, ANGEL NP","ppno":5402245775,"pcpadd":"3 RIVERSIDE CIR,","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":"24016-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4342001700,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C50.411","Z17.0","H26.491","Z51.11","Z08.","Z90.13","Z79.811","H25.11","T85.22XA","F32.89","G64.","Z40.01","Z42.1","C50.911","J45.909","M96.843","L90.5","Z45.2","Z98.82","Z79.810","Z92.21","J45.20","K21.9","Z79.1","M54.9","R10.9","R42.","R14.0","R11.0","H26.9","A69.20","R10.84","Z86.19","Z13.820","T85.49XA","C50.919","Z92.3","M54.16","M51.36","H54.7","M16.12","M17.12","Z12.11","K63.5","K57.30","M65.332","M43.16","M47.26","M51.16","M17.0","M48.07","M46.06"],"date":["2023-09-11","2023-09-11","2022-12-27","2022-06-03","2023-05-26","2023-05-26","2022-11-14","2022-06-16","2022-07-14","2023-03-17","2022-05-13","2022-07-26","2022-07-26","2023-05-26","2022-10-10","2022-10-10","2022-10-10","2022-10-10","2022-10-10","2022-10-10","2022-10-10","2022-10-10","2022-10-10","2022-10-10","2023-01-10","2023-01-10","2023-01-10","2023-01-10","2023-01-10","2023-03-17","2023-03-17","2023-03-17","2023-03-17","2023-03-17","2022-10-10","2022-10-10","2023-05-26","2023-06-27","2023-06-27","2023-06-28","2023-08-14","2023-08-14","2023-08-25","2023-08-25","2023-08-25","2023-08-29","2023-09-01","2023-09-01","2023-09-01","2023-09-01","2023-09-01","2023-09-01"],"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":[["","13668000901","CITALOPRAM","TAB 10MG","30","Select","Select",""],["","61314012605","KETOROLAC","SOL 0.005","5","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","42","Select","Select",""],["","68382020906","ANASTROZOLE","1 MG","30","Select","Select",""],["","81131031282","D3","CAP 2000UNIT","4","Select","Select",""],["","60758011905","PREDNISOLONE","SUS 1% OP","5","Select","Select",""],["","17478071310","OFLOXACIN","DRO 0.3% OP","5","Select","Select",""],["","00172392560","DIAZEPAM","TAB 2MG","10","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","20","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","65162027250","SMZ\/TMP DS","TAB 800-160","28","Select","Select",""],["","45802086803","POLYETHYLENE GLYCOL","3350 17 G\/DOSE","3060","Select","Select",""],["","68682010301","DICLOFENAC SODIUM ER","100 MG","10","Select","Select",""],["","29300041519","CYCLOBENZAPRINE HCL","10 MG","30","Select","Select",""],["","59746017509","PREDNISONE","20 MG","7","Select","Select",""],["","81131000720","D","3 CAP 2000UNIT","4","Select","Select",""],["","17478071310","OFLOXACIN DRO","0.3% OP","5","Select","Select",""],["","61314012605","KETOROLAC SOL","0.5%","5","Select","Select",""],["","13668000901","CITALOPRAM TAB","10MG","30","Select","Select",""],["","42858000101","OXYCODONE TAB","5MG","42","Select","Select",""],["","16729003516","ANASTROZOLE TAB","1MG","30","Select","Select",""],["","60758011905","PREDNISOLONE SUS","1% OP","5","Select","Select",""],["","00172392560","DIAZEPAM TAB","2MG","20","Select","Select",""],["","68462015713","ONDANSETRON TAB","4MG ODT","10","Select","Select",""],["","31722099601","HYDROCO\/APAP TAB","5-325MG","20","Select","Select",""],["","65162027250","SMZ\/TMP DS TAB","800-160","28","Select","Select",""],["","65162019011","NAPROXEN","500 MG","14","Select","Select",""],["","68382005105","MELOXICAM","15 MG","30","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":""}]}]}