{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANGELA WEBSTER","gend":1,"add":"1505 GILLIAM DR","city":"FARMVILLE","state":"VA","zip":"23901-9998","dob":"1981-10-03","age":"","mstatus":"","insh":"7079877*01","cliId":"","pno":8042776692,"cno":8042776692,"email":"","ename":"","eno":"","pphy":"HUYNH, VINH THINH T MD","ppno":4343155340,"pcpadd":"935 S MAIN ST,","pcpcity":"FARMVILLE","pcpstate":"VA","pcpzip":"23901-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4343152859,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","F17.200","F33.1","Z13.89","Z51.81","V54.17","V54.11","M50.30","F17.210","Z46.6","Z98.1","Z91.81","I10.","S22.080S","M51.04","S32.010S","F41.9","F33.9","S22.089A","S32.019A","G89.18","L76.34","R20.0","R53.1","F41.8","NO DATA","R52.","S42.251A","S46.011A","M54.14","V89.2XXA","S46.801A","S22.081A","M25.511","M75.01","M89.8X9","S42.251K","M12.811","M61.00","G90.519","S22.000A","Z72.0","Z47.2","M54.12","Z20.822","D50.9","Z88.8","R33.9","G89.11","M43.24","R03.0","R05.9","R09.81","H92.09","M25.512","S46.812A","X50.9XXA","V49.50XA","Y92.410","S34.109S","S32.008S","M50.323","M54.2","M99.01","Z68.39","M24.611","S61.217A","W25.XXXA","Z86.59","V58.89","N39.0","M25.561","Z20.828","M17.11","Z68.38","N30.01","R29.898","R32.","R22.43","S86.911A","W19.XXXA"],"date":["2023-09-13","2023-09-13","2022-08-19","2022-03-07","2022-03-07","2022-02-14","2022-05-25","2022-02-14","2023-08-19","2022-02-14","2022-11-01","2022-02-14","2022-06-11","2022-11-16","2023-03-24","2022-11-16","2023-05-01","2022-03-07","2022-01-03","2021-12-29","2022-11-22","2022-11-22","2022-11-22","2022-11-22","2022-11-22","2022-11-22","2021-12-29","2022-01-10","2023-09-14","2022-08-22","2022-01-04","2022-01-06","2022-04-05","2023-01-25","2023-01-25","2023-01-05","2023-01-05","2022-09-12","2022-09-12","2022-09-12","2022-09-12","2023-09-08","2022-11-16","2021-12-17","2021-12-29","2021-12-29","2021-12-29","2021-12-29","2022-01-02","2022-01-04","2022-06-11","2022-06-11","2022-06-11","2022-06-11","2021-12-10","2021-12-10","2021-12-10","2021-12-29","2021-12-29","2023-05-26","2023-05-26","2023-06-23","2023-06-23","2023-06-23","2023-06-23","2023-08-11","2023-08-19","2023-08-19","2023-08-19","2023-08-11","2023-09-05","2023-09-08","2023-09-05","2023-09-08","2023-09-08","2023-08-31","2023-08-31","2023-08-31","2023-09-01","2023-09-14","2023-09-14"],"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":[["","51991074890","DULOXETINE","CAP 60MG","60","Select","Select",""],["","12496120803","SUBOXONE","8 MG-2 MG","42","Select","Select",""],["","69584061250","METHOCARBAM","TAB 750MG","80","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","28","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","20","Select","Select",""],["","00591352530","LIDOCAINE","5 %","30","Select","Select",""],["","69097094312","GABAPENTIN","300 MG","90","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","28","Select","Select",""],["","00781717612","NALOXONE","SPR ","2","Select","Select",""],["","50428029464","CVS SENNA PL","TAB 8.6-50MG","60","Select","Select",""],["","53746020301","OXYCOD\/APAP","TAB 5-325MG","42","Select","Select",""],["","00093216568","NALOXONE HCL","4 MG","2","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","12","Select","Select",""],["","60505025203","TIZANIDINE","TAB 4MG","60","Select","Select",""],["","00228212750","CLONIDINE","TAB 0.1MG","24","Select","Select",""],["","00536100901","FERROUS SULF","TAB 325MG","30","Select","Select",""],["","50428026496","CVS SENNA","TAB 8.6MG","60","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","64380078706","BUSPIRONE","TAB 7.5MG","28","Select","Select",""],["","65862048901","QUETIAPINE","TAB 25MG","28","Select","Select",""],["","47781035703","BUPREN\/NALOX","MIS 8-2MG","18","Select","Select",""],["","45802011222","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","00904699860","DOCUSATE SOD","CAP 100MG","60","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","8","Select","Select",""],["","00378034505","DIAZEPAM","TAB 5MG","1","Select","Select",""],["","69097083412","SERTRALINE HCL","50 MG","28","Select","Select",""],["","13107008405","LORAZEPAM","1 MG","2","Select","Select",""],["","00536100901","FERROUS SULF TAB","325MG","30","Select","Select",""],["","10702001801","OXYCODONE TAB","5MG","30","Select","Select",""],["","50428029464","CVS SENNA PL TAB","8.6-50MG","60","Select","Select",""],["","70010077005","METHOCARBAM TAB","750MG","60","Select","Select",""],["","69547035302","NARCAN SPR","","2","Select","Select",""],["","50428026496","CVS SENNA TAB","8.6MG","60","Select","Select",""],["","65162010250","GABAPENTIN CAP","300MG","90","Select","Select",""],["","00781717612","NALOXONE SPR","","2","Select","Select",""],["","00591352530","LIDOCAINE PAD","5%","30","Select","Select",""],["","60505025203","TIZANIDINE TAB","4MG","60","Select","Select",""],["","53746020301","OXYCOD\/APAP TAB","5-325MG","42","Select","Select",""],["","00093216568","NALOXONE HCL SPR","4MG","2","Select","Select",""],["","69097083412","SERTRALINE TAB","50MG","28","Select","Select",""],["","64380078706","BUSPIRONE TAB","7.5MG","28","Select","Select",""],["","12496120803","SUBOXONE MIS","8-2MG","70","Select","Select",""],["","47781035703","BUPREN\/NALOX MIS","8-2MG","18","Select","Select",""],["","65862048901","QUETIAPINE TAB","25MG","28","Select","Select",""],["","65162052110","PROMETHAZINE TAB","25MG","12","Select","Select",""],["","00228212750","CLONIDINE TAB","0.1MG","24","Select","Select",""],["","00378034505","DIAZEPAM TAB","5MG","1","Select","Select",""],["","00116200116","CHLORHEX GLU SOL","0.12%","473","Select","Select",""],["","00904699860","DOCUSATE SOD CAP","100MG","60","Select","Select",""],["","45802011222","MUPIROCIN OIN","2%","22","Select","Select",""],["","53746010901","HYDROCO\/APAP TAB","5-325MG","8","Select","Select",""],["","71205075505","PREDNISONE","50 MG","5","Select","Select",""],["","00054018913","BUPRENORPHINE-NALOXONE","8 MG-2 MG","42","Select","Select",""],["","43547056511","CLONIDINE HCL","0.1 MG","9","Select","Select",""],["","29300014701","QUETIAPINE FUMARATE","25 MG","3","Select","Select",""],["","65862039010","ONDANSETRON ODT","4 MG","9","Select","Select",""],["","76385012450","METHOCARBAMOL","750 MG","30","Select","Select",""],["","68180012202","CEPHALEXIN","500 MG","28","Select","Select",""],["","00406012301","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","30","Select","Select",""],["","16571020106","DICLOFENAC SODIUM","75 MG","28","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":""}]}]}