{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LAMESHA  C ECHOLS","gend":1,"add":"104 N HILLS CT APT A","city":"DANVILLE","state":"VA","zip":"24541-9998","dob":"1978-05-19","age":"","mstatus":"","insh":"8611467*01","cliId":"","pno":4344210483,"cno":4344210483,"email":"","ename":"","eno":"","pphy":"SMITH, DAVID B PA","ppno":4348350105,"pcpadd":"2767 FRANKLIN TURNPIKE,","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24540-9998","pcpcounty":"","pcpid":"","pcpname":"Sovah Pulmonary - Danville ","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4348350178,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.1","F33.1","F31.81","I16.1","I10.","F41.9","A54.9","A59.9","N76.0","R60.9","N93.9","F31.9","J01.90","F32.89","R07.9","I11.0","I50.9","E07.9","R51.9","R52.","R07.89","R11.0","R10.12","B37.9","H10.33","Z20.822","R05.9","R06.2","Z87.09","J40.","I11.9","R01.1","J06.9","D72.828","E83.39","E06.9","E04.1","D64.9","D35.1","E66.9","D50.9","E83.52","R94.6","F17.210","Z79.899","R06.02","H53.8","K02.9","Z87.891","K08.89","A54.02","N39.0","NO DATA","R10.32","Z76.89","J44.9","H66.92"],"date":["2021-04-05","2022-11-10","2022-11-10","2023-01-06","2023-07-24","2021-04-23","2022-05-13","2022-05-13","2023-03-20","2022-05-13","2022-05-13","2022-08-24","2023-05-12","2022-11-16","2023-01-06","2022-11-30","2022-11-30","2023-07-24","2023-01-06","2021-04-17","2021-04-20","2021-04-20","2023-03-20","2023-03-20","2023-03-20","2023-03-20","2022-09-16","2022-09-16","2022-09-16","2022-09-16","2022-11-30","2021-04-21","2022-08-29","2021-04-14","2021-04-14","2021-04-14","2021-04-14","2021-04-14","2021-04-14","2021-04-14","2021-04-14","2021-04-14","2021-04-14","2023-07-24","2021-04-14","2021-04-14","2021-04-14","2021-04-26","2021-04-26","2021-04-26","2022-05-13","2023-03-20","2023-03-20","2023-03-20","2023-07-24","2023-07-24","2023-07-24"],"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":[["","67877025001","QUETIAPINE","TAB 100MG","30","Select","Select",""],["","68462013701","OXCARBAZEPIN","TAB 150MG","180","Select","Select",""],["","43547028110","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","59651039001","BUSPIRONE","TAB 7.5MG","60","Select","Select",""],["","00517420125","HYDROXYZ HCL","INJ 25MG\/ML","60","Select","Select",""],["","43547028910","BUPROPION","TAB 150MG SR","30","Select","Select",""],["","16571066450","METRONIDAZOL","TAB 500MG","10","Select","Select",""],["","59267102501","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","00143211205","DOXYCYCL HYC","TAB 100MG","14","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","00093310905","AMOXICILLIN","500 MG","20","Select","Select",""],["","00603533815","PREDNISONE","10 MG","21","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","120","Select","Select",""],["","68180051902","LISINOP\/HCTZ","TAB 20-12.5","20","Select","Select",""],["","67877025001","QUETIAPINE FUMARATE","100 MG","30","Select","Select",""],["","65862020299","LOSARTAN POTASSIUM","50 MG","30","Select","Select",""],["","43547028910","BUPROPION HCL SR","150 MG","30","Select","Select",""],["","68462013701","OXCARBAZEPINE","150 MG","180","Select","Select",""],["","00574402435","ERYTHROMYCIN","5 MG\/GRAM","3.5","Select","Select",""],["","72888000405","METOPROLOL TARTRATE","25 MG","60","Select","Select",""],["","57237000511","FLUCONAZOLE","150 MG","1","Select","Select",""],["","68180072103","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","43547028110","ESCITALOPRAM OXALATE","10 MG","30","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","14","Select","Select",""],["","00536132701","ACETAMINOPHEN","325 MG","50","Select","Select",""],["","50111033402","METRONIDAZOLE","500 MG","14","Select","Select",""],["","65862050220","AMOXICILLIN-CLAVULANATE POTASS","500-125 MG","21","Select","Select",""],["","27808005701","PROMETHAZINE-DM","6.25-15\/5","120","Select","Select",""],["","67877025001","QUETIAPINE TAB","100MG","30","Select","Select",""],["","68462013701","OXCARBAZEPIN TAB","150MG","60","Select","Select",""],["","43547028110","ESCITALOPRAM TAB","10MG","30","Select","Select",""],["","59651039001","BUSPIRONE TAB","7.5MG","60","Select","Select",""],["","00517420125","HYDROXYZ HCL INJ","25MG\/ML","60","Select","Select",""],["","43547028910","BUPROPION TAB","150MG SR","30","Select","Select",""],["","16571066450","METRONIDAZOL TAB","500MG","10","Select","Select",""],["","68180072103","AMLODIPINE TAB","10MG","30","Select","Select",""],["","59267102501","PFIZER VACC INJ ADLT RTU","","0","Select","Select",""],["","00143211205","DOXYCYCL HYC TAB","100MG","14","Select","Select",""],["","60432060416","PROMETHAZINE SYP DM","","120","Select","Select",""],["","65862001705","AMOXICILLIN CAP","500MG","20","Select","Select",""],["","00591544210","PREDNISONE TAB","10MG","10","Select","Select",""],["","00781808926","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","68180051902","LISINOP\/HCTZ TAB","20-12.5","20","Select","Select",""],["","00904723760","BANOPHEN","25 MG","24","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","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":""}]}]}