{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"A   NAYRBNOTNILC ","gend":0,"add":"ROMACYS S 412112 TPA TS E","city":"PETERSBURG","state":"VA","zip":"23803-9998","dob":"1974-08-27","age":"","mstatus":"","insh":"55200210*30","cliId":"","pno":"46\/2522910-0","cno":"","email":"","ename":"","eno":"","pphy":"ANDERSON, MICHAEL S MD","ppno":"434\/634-6101","pcpadd":"6 DOCTORS DRIVE","pcpcity":"EMPORIA","pcpstate":"VA","pcpzip":23847,"pcpcounty":"","pcpid":"","pcpname":"EMPORIA MEDICAL ASSOCIATES PC","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":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N18.6","Z99.2","R06.00","R10.9","Z53.21","R07.89","R60.0","Z91.15","E87.5","D63.1","N25.81","E87.70","I12.0","E87.2","R60.9","J96.00","I50.32","J96.01","Z91.19","I21.4","I10.","F20.9","K08.9","N18.9","E66.9","Z79.899","Z68.36","I13.2","I50.9","E21.1","R42.","R53.81","R53.83","R53.1","Z86.718","I50.33","E87.6","F25.9","K21.9","Z91.040","C18.0","R06.02","E66.01","F31.9","F41.9","F60.3","F79.","G47.33","I45.10","R74.8","F25.0","E16.0","Z68.39","Z20.822","T38.3X5A","Z78.1","I50.40","R05.","F99.","K63.89","Z53.09","R62.50","I13.11","R60.1","G24.01","Z87.19","Z71.3","Z76.0","N40.0","G20.","R58.","R09.02","R19.7","K62.5","N19.","F89.","F63.9","F31.60","R07.9","I12.9","S40.022A","E83.39","E83.52","E78.00","R45.1","E11.9","F31.81","R33.9","K11.7","R09.81","N30.01","Z46.6","N48.89","D50.9","R19.5","D12.4","J81.1","R14.0","N50.812","Z91.14","N48.1","L29.9","R30.0","N25.0","R45.87","F91.9","D64.9","J30.9","Z00.8","R79.89","I25.2","K92.2","D62.","R55.","F88.","R11.2","R00.0","K92.1","J32.9","F70.","Z49.31","J01.90","D12.0","K80.00","K44.9","K64.9","K21.0","J81.0"],"date":["2021-12-25","2021-12-31","2021-12-24","2021-12-24","2021-12-24","2020-01-10","2021-12-18","2021-12-25","2021-12-31","2021-12-25","2021-12-09","2021-12-25","2021-12-09","2021-11-13","2021-11-26","2021-11-18","2021-11-17","2021-11-20","2021-11-20","2021-11-18","2021-12-09","2021-12-09","2021-12-31","2021-12-31","2021-12-31","2021-12-31","2021-12-31","2021-11-13","2021-11-18","2020-01-19","2021-12-22","2021-12-18","2021-12-18","2021-12-18","2021-12-22","2020-01-08","2020-01-08","2020-02-10","2020-01-08","2020-01-08","2020-01-13","2020-01-13","2021-11-13","2021-11-13","2021-11-14","2021-12-25","2021-12-25","2021-11-13","2021-11-13","2021-11-16","2021-12-25","2021-12-25","2021-12-25","2021-12-25","2021-12-25","2021-12-25","2020-01-08","2020-02-06","2020-02-06","2020-02-12","2020-02-10","2020-02-10","2020-02-12","2021-01-12","2021-12-22","2021-12-22","2021-12-22","2019-12-21","2019-12-21","2019-12-21","2019-12-23","2019-12-23","2019-12-28","2019-12-24","2019-07-29","2019-07-05","2019-07-24","2019-07-29","2019-08-18","2019-11-21","2019-11-01","2019-06-26","2019-06-26","2019-03-27","2019-06-26","2019-05-23","2019-06-14","2019-10-27","2019-08-04","2019-08-07","2019-08-17","2019-10-31","2019-10-31","2019-12-11","2019-12-11","2019-12-11","2019-12-23","2019-12-23","2019-12-23","2019-12-23","2019-12-28","2019-05-08","2019-06-26","2019-08-09","2019-06-26","2019-06-26","2019-12-11","2019-06-05","2019-03-22","2019-03-22","2019-05-13","2019-05-29","2019-05-29","2019-07-24","2019-07-24","2019-08-14","2019-12-24","2019-12-24","2019-06-09","2019-06-21","2019-08-09","2019-11-11","2019-12-09","2019-12-09","2019-12-09","2019-12-09","2019-12-09","2019-12-15"],"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":[["","68382013201","TAMSULOSIN","CAP 0.4MG","10","Select","Select",""],["","00832059011","DIPHEN\/ATROP","TAB ","10","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":""}]}]}