{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"L  EGROEGNOTLIMAH ","gend":0,"add":"TBARC 379WLOH EER","city":"CLINTWOOD","state":"VA","zip":24228,"dob":"1960-09-27","age":"","mstatus":"","insh":"48200210*89","cliId":"","pno":"29\/6723415-6","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"276\/679-0321","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":24228,"pcpcounty":"","pcpid":"","pcpname":"WELLMONT MEDICAL ASSOCIATES INC","plan":"OHP","program":"Medicaid","lob":"OHCC","region":"SOUTHWEST","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":["M25.551","M25.552","G89.29","F41.9","F32.9","I08.2","R53.81","D50.9","E78.5","E11.9","I10.","E78.2","R53.83","K21.9","Z79.899","I48.91","I48.92","I06.0","Z23.","M25.512","I48.0","NO DATA","E66.09","Z68.33","I48.3","E53.8","Z00.00","D64.9","R06.02","R01.1","I38.","F11.90","Z12.11","Z79.01","M32.9","M53.3","Z95.2","I35.0","R04.0","M54.5","I35.2","I36.1","Z79.84","F33.9","Z87.891","Z01.810","R00.0","I49.9","M54.9","M47.816"],"date":["2021-11-29","2021-11-29","2022-09-28","2021-05-13","2021-05-13","2021-04-26","2020-01-09","2021-04-15","2020-01-09","2022-02-23","2022-02-23","2022-03-23","2020-01-09","2021-10-28","2022-09-21","2021-04-26","2021-04-26","2021-09-01","2021-11-29","2022-02-23","2021-11-29","2020-05-15","2020-09-28","2020-09-28","2020-12-23","2021-04-15","2022-02-23","2021-09-01","2021-05-13","2021-05-13","2021-08-19","2020-08-28","2021-02-17","2021-09-01","2019-02-21","2022-09-28","2019-10-29","2019-12-11","2019-01-10","2019-01-29","2019-03-25","2019-03-25","2019-03-25","2019-03-25","2019-03-25","2019-04-29","2019-03-27","2019-11-11","2022-09-28","2022-09-28"],"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":[["","00378718705","METFORMIN","TAB 1000MG","60","Select","Select",""],["","00310621030","FARXIGA","TAB 10MG","30","Select","Select",""],["","51672403001","WARFARIN","TAB 3MG","30","Select","Select",""],["","68180046403","SIMVASTATIN","TAB 40MG","30","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","60","Select","Select",""],["","59651000205","OMEPRAZOLE","CAP 20MG","60","Select","Select",""],["","00378003210","METOPROL","TAB 50MG","60","Select","Select",""],["","64980028101","GLIPIZIDE","TAB 10MG","30","Select","Select",""],["","","VITAMIN","TAB 500MG","","Select","Select",""],["","68382009705","PAROXETINE","TAB 10MG","30","Select","Select",""],["","00904699860","DOCUSATE","CAP 100MG","90","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","","FERROUS","TAB 324MG","","Select","Select",""],["","00363023820","STOOL","CAP 100MG","30","Select","Select",""],["","68180029606","DULOXETINE","CAP 60MG","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","51672126906","BETAMETH","CRE 0.001","45","Select","Select",""],["","64980043710","ATENOLOL","TAB 25MG","30","Select","Select",""],["","00173068220","VENTOLIN","AER ","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":""}]}]}