{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" YORTRRAC","gend":0,"add":"SRRAC 5333YWH ELLIV","city":"FRANKLIN","state":"VA","zip":"23851-9998","dob":"1987-06-15","age":"","mstatus":"","insh":"50500210*87","cliId":"","pno":"72\/7571839-4","cno":"757\/274-9381","email":"","ename":"","eno":"","pphy":"HARRISON, REID CHAMBERS MD","ppno":"757\/304-5570","pcpadd":"1357 ARMORY DRIVE","pcpcity":"FRANKLIN","pcpstate":"VA","pcpzip":23851,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","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":["K21.9","I10.","M51.16","R13.10","R10.13","M54.16","M50.10","Z86.39","J45.20","M54.9","Z01.818","M50.122","Z98.1","M54.6","R10.32","S46.819A","Z68.25","M50.222"],"date":["2020-07-24","2022-10-14","2020-07-29","2020-07-24","2020-07-24","2020-08-21","2022-10-14","2020-01-23","2020-01-23","2020-07-17","2020-01-14","2020-01-23","2020-02-11","2020-08-21","2022-10-14","2022-10-14","2022-10-14","2020-01-23"],"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":[["","68645051554","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","00406012501","HYDROCO\/APAP","TAB 10-325MG","35","Select","Select",""],["","67877022310","GABAPENTIN","CAP 300MG","60","Select","Select",""],["","70010077005","METHOCARBAM","TAB 750MG","90","Select","Select",""],["","10370083111","DILTIAZEM","CAP 240MG ER","30","Select","Select",""],["","64764017530","DEXILANT","CAP 60MG DR","90","Select","Select",""],["","00069046903","CHANTIX","PAK 1MG","56","Select","Select",""],["","62037059905","CARTIA","CAP 240\/24HR","30","Select","Select",""],["","45802008801","ALBUTEROL","AER HFA","8","Select","Select",""],["","65162067684","AZELASTINE","SPR 0.001","30","Select","Select",""],["","69543038810","KETOROLAC","TAB 10MG","15","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","90","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":""}]}]}