{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"W DIVADNNADRE","gend":0,"add":"LTAC 2392DAOR TTE","city":"CHARLOTTESVILLE","state":"VA","zip":"22901-9998","dob":"1981-11-04","age":"","mstatus":"","insh":"9062210*81","cliId":"","pno":"3223726876","cno":"","email":"","ename":"","eno":"","pphy":"NADKARNI, MOHAN MD","ppno":4349241931,"pcpadd":"1222 JEFFERSON PARK AVE","pcpcity":"CHARLOTTESVILLE","pcpstate":"VA","pcpzip":"22903-9998","pcpcounty":"","pcpid":"","pcpname":"UNIVERSITY OF VIRGINIA PHYSICIANS GROUP","plan":"OHP","program":"ACA","lob":"Individual","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":["G93.40","F10.29","F15.99","F14.99","F11.90","E11.65","R31.0","R09.02","Z46.82","J98.4","U07.1","J96.01","N17.9","G93.41","J69.8","M62.81","G92.8","K70.10","F19.10","E87.0","D69.6","K70.30","D61.818","F10.20","F19.90","Z53.21","R41.89","R91.8","A41.89","R65.21","N17.0","J69.0","J12.82","D68.9","E87.1","I82.613","K76.6","F14.10","F10.10","J98.11","J90.","K70.9","L03.116","L03.115","Z72.0","Z20.828","M79.89","R73.9","R73.03","R31.9","N62.","N63.0","Z80.8","Z80.0","S01.01XA","S01.81XA","Z46.59","S19.9XXA","M48.02","E87.6","E83.39","F10.11","W19.XXXA","Y93.9","Y92.009","I82.622","K83.9","K76.0","K74.60","K83.8","K80.20","R01.1","J18.9","L03.119","Z20.822","Z86.16","Z99.11","Z79.899","K72.00","F10.99","Z99.81","I82.611","I82.612","Z51.81","K74.5","Z79.01","J20.9","A41.9","F14.90","Z53.8","I10.","G47.30"],"date":["2022-03-04","2022-03-01","2022-03-01","2022-03-01","2022-03-01","2022-10-22","2022-10-22","2022-02-11","2022-02-16","2022-02-13","2022-04-04","2022-04-04","2022-04-04","2022-03-04","2022-04-04","2022-04-04","2022-04-04","2022-09-22","2022-04-04","2022-04-04","2022-04-04","2022-05-12","2022-03-15","2022-03-15","2022-03-15","2022-04-19","2022-02-10","2022-02-16","2022-02-10","2022-02-10","2022-02-14","2022-02-14","2022-02-15","2022-03-31","2022-02-10","2022-03-02","2022-02-11","2022-02-10","2022-09-22","2022-02-14","2022-02-14","2022-10-22","2022-05-12","2022-05-12","2022-05-12","2022-05-12","2022-05-12","2022-10-22","2022-10-22","2022-10-22","2022-01-25","2022-01-25","2022-01-25","2022-01-25","2022-02-10","2022-02-10","2022-02-15","2022-02-10","2022-02-10","2022-02-10","2022-02-10","2022-02-21","2022-02-10","2022-02-10","2022-02-10","2022-03-02","2022-03-31","2022-02-11","2022-02-11","2022-02-11","2022-02-11","2022-02-15","2022-02-17","2022-05-12","2022-05-12","2022-05-12","2022-02-14","2022-02-10","2022-02-15","2022-02-15","2022-02-15","2022-03-02","2022-03-02","2022-03-02","2022-03-02","2022-03-02","2022-02-11","2022-02-14","2022-02-14","2022-09-22","2022-09-22","2022-09-22"],"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":[["","51991070505","ALPRAZOLAM","TAB 0.5MG","30","Select","Select",""],["","13668013610","ESCITALOPRAM","TAB 10MG","45","Select","Select",""],["","13107003134","MIRTAZAPINE","TAB 15MG","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":""}]}]}