{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  SENGAEGNI H ","gend":1,"add":"RPS 011TS ECU","city":"DANVILLE","state":"VA","zip":"24541-9998","dob":"1945-06-07","age":"","mstatus":"","insh":"04000910*206","cliId":"","pno":"07\/4345613-9","cno":"434\/709-3165","email":"","ename":"","eno":"","pphy":"JANNACH, STEPHAN H MD","ppno":"434\/793-4711","pcpadd":"109 BRIDGE STREET SUITE 300","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"SPECTRUM MEDICAL INC","plan":"OHP","program":"MEDICARE","lob":"MA-Non DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M65.4","M19.042","M67.362","M25.562","G89.29","E11.9","I10.","D50.0","E78.2","F41.9","F32.9","L29.9","Z12.31","I25.10","I44.1","R60.9","I87.2","I73.9","I48.0","M51.36","Z79.01","M25.532","M67.361","M25.561","M17.11","R11.0","R93.5","L30.9","L53.9","M17.12","M54.16","M54.50","M25.551"],"date":["2021-08-27","2021-02-05","2021-05-25","2021-09-24","2021-05-25","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-03-05","2021-03-05","2021-12-17","2021-06-18","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2021-12-03","2021-07-30","2021-07-30","2021-09-24","2021-09-24","2021-09-24","2021-07-23","2021-07-23","2021-12-20","2021-12-20","2021-01-08","2021-12-03","2021-12-03","2021-12-03"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","31722099601","HYDROCO\/APAP","TAB 5-325MG","60","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","50458057989","XARELTO","TAB 20MG","30","Select","Select",""],["","57237001760","DULOXETINE","CAP 20MG","90","Select","Select",""],["","60505024701","MIRTAZAPINE","TAB 15MG","90","Select","Select",""],["","65862078430","ESOMEPRA","CAP 40MG DR","90","Select","Select",""],["","00093505998","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","68645019159","METOPROL","TAB 100MG","60","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","90","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","90","Select","Select",""],["","68645051054","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","69238153205","CLOBETASOL","CRE 0.0005","15","Select","Select",""],["","68645014059","FAMOTIDINE","TAB 20MG","90","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","45802005935","NYSTATIN","CRE 100000","15","Select","Select",""],["","68645058259","METFORMIN","TAB 500MG","180","Select","Select",""],["","16714008210","HYDROXYZ","TAB 25MG","180","Select","Select",""],["","00168005646","BETAMETH","OIN 0.0005","45","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","00603533715","PREDNISONE","PAK 5MG","21","Select","Select",""],["","59267102501","PFIZER","INJ ADLT RTU","0","Select","Select",""],["","68382004101","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","40","Select","Select",""],["","43598021055","SSD","CRE 0.01","50","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":""}]}]}