{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ARDNEKNWORB ","gend":1,"add":"SELWAL 5211DR KEERC S","city":"BLAIRS","state":"VA","zip":"24527-9998","dob":"2002-06-02","age":"","mstatus":"","insh":"54200210*86","cliId":"","pno":"84\/4340863-9","cno":"","email":"","ename":"","eno":"","pphy":"BAILEY, ALLISON R NP","ppno":"434\/656-2224","pcpadd":"305 N MAIN ST","pcpcity":"GRETNA","pcpstate":"VA","pcpzip":24557,"pcpcounty":"","pcpid":"","pcpname":"DANVILLE PHYSICIAN PRACTICES LLC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","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":["L72.9","Z79.3","F90.2","F43.23","F91.3","S42.001A","S49.91XA","G54.0","H66.92","V58.89","M86.611","J32.2","R09.82","B00.1","M85.88","Z09.","J30.2","F90.1","N94.6","M25.511","Z23.","R53.83","R53.1","R42.","K12.1","Z01.419","N76.0","B96.89","M89.8X1","N89.8","D48.5","R59.0","Q82.5","D22.5","J02.9","R50.9","B34.9","Z45.2","M86.68","M86.619","V54.19","M85.811","M85.821","Z47.89","Z00.00","J06.9","Z20.828","Z77.22"],"date":["2019-02-13","2019-02-13","2020-07-09","2020-07-09","2020-07-09","2021-03-26","2021-03-26","2021-03-26","2021-09-01","2021-09-29","2021-09-29","2019-05-24","2019-05-24","2020-01-13","2021-02-04","2021-03-16","2021-03-16","2021-03-16","2021-03-16","2019-10-16","2019-10-15","2020-01-10","2020-01-10","2020-01-10","2020-01-10","2020-07-21","2020-07-21","2020-07-21","2020-10-02","2021-04-28","2019-04-16","2019-04-16","2019-04-16","2019-04-16","2019-10-01","2019-10-01","2019-10-01","2021-02-17","2021-03-30","2021-03-31","2020-10-21","2021-02-04","2021-09-29","2021-09-29","2020-08-25","2020-09-03","2020-09-03","2020-09-03"],"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":[["","","AMOXICILLIN"," AMOXICILLIN ","20","Select","Select",""],["","","CETIRIZINE"," CETIRIZINE ","30","Select","Select",""],["","","JUNEL"," JUNEL ","21","Select","Select",""],["","","METHYLPRED"," METHYLPRED ","21","Select","Select",""],["","","AZELASTINE"," AZELASTINE ","30","Select","Select",""],["","","MONTELUKAST"," MONTELUKAST ","30","Select","Select",""],["","","CLINDAMYCIN"," CLINDAMYCIN ","21","Select","Select",""],["","","DICLOFENAC"," DICLOFENAC ","60","Select","Select",""],["","","METHYLPHENID","TAB 10MG","","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","","VALACYCLOVIR","TAB 500MG","","Select","Select",""],["","","TRIAMCINOLON","PST DEN 0.1%","","Select","Select",""],["","","NYSTATIN","SUS 100000","","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","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":""}]}]}