{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"L  NERRADNOSPMAS ","gend":0,"add":"EERG 1093DR TNUOMN","city":"HARRISONBURG","state":"VA","zip":22802,"dob":"1995-03-16","age":"","mstatus":"","insh":"44300210*45","cliId":"","pno":"38\/0450864-3","cno":"","email":"","ename":"","eno":"","pphy":"Lepley, Shawn","ppno":"540\/564-7300","pcpadd":"1661 South Main Street ","pcpcity":"Harrisonburg","pcpstate":"VA","pcpzip":22802,"pcpcounty":"","pcpid":"","pcpname":"SRMHMG - Sentara South Main Health Center","plan":"OHP","program":"Medicaid","lob":"OHCC","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.65","E55.9","E78.1","F84.0","H61.20","F40.10","L85.1","E11.9","M21.41","M21.42","S01.401A","H61.22","Z00.00","R21."],"date":["2021-10-08","2021-10-08","2021-10-08","2021-05-14","2020-10-28","2020-06-24","2021-11-12","2021-11-12","2021-11-12","2021-11-12","2020-11-17","2020-11-17","2019-10-09","2019-08-01"],"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":{"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":[["","00002143480","TRULICITY","INJ 1.5\/0.5","2","Select","Select",""],["","00093727205","PIOGLITAZONE","TAB 30MG","30","Select","Select",""],["","29300024716","BUSPIRONE","TAB 30MG","30","Select","Select",""],["","50458014130","INVOKANA","TAB 300MG","30","Select","Select",""],["","70010049105","METFORMIN","TAB 500MG ER","360","Select","Select",""],["","65862001205","SERTRALINE","TAB 50MG","45","Select","Select",""],["","68180038909","FENOFIBRATE","TAB 145MG","90","Select","Select",""],["","16729004417","ATORVASTATIN","TAB 10MG","90","Select","Select",""],["","69367022918","SELENIUM","SHA 0.0225","180","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}