{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" L   KCAJRJ REKLAW","gend":0,"add":"OOC 611TS REP","city":"DANVILLE","state":"VA","zip":"24540-9998","dob":"1967-07-12","age":"","mstatus":"","insh":"76300210*55","cliId":"","pno":"27\/4345410-8","cno":"","email":"","ename":"","eno":"","pphy":"CONDER, BRYAN DO","ppno":"434\/799-4488","pcpadd":"109 BRIDGE STREET SUITE 201","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"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":["NO DATA","K63.89","Z93.2","Z43.3","E78.00","I10.","J30.9","K21.9","Z43.2","Z09.","F17.218","H11.041","H25.13","H02.89","K57.32","R65.10","K63.9","E83.39","E83.42","K42.9","F17.210","R59.9","E66.9","E78.5","Z90.49","Z80.0","Z79.899","H10.413","H11.051","C18.9","J01.40","R53.81","Z87.19","Z48.02","J31.0","J01.90","R59.0","H11.001","K43.2","F17.200","K43.9","J06.9","R03.0","R09.81","J32.9"],"date":["2021-08-16","2021-03-21","2021-05-24","2021-04-02","2021-04-02","2021-04-02","2021-06-07","2021-06-07","2021-06-17","2021-04-07","2021-04-07","2021-08-16","2021-08-16","2021-08-16","2021-03-21","2021-03-21","2021-03-22","2021-03-21","2021-03-21","2021-03-21","2021-03-22","2021-03-21","2021-03-21","2021-03-21","2021-06-17","2021-03-21","2021-03-21","2022-04-13","2022-01-12","2021-03-21","2021-04-08","2021-04-02","2021-06-17","2021-07-18","2022-10-11","2022-09-20","2022-10-11","2022-04-13","2022-10-04","2022-10-04","2022-08-12","2022-08-12","2022-08-12","2022-10-11","2022-10-11"],"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":[["","33342006410","VALSARTAN","TAB 160MG","90","Select","Select",""],["","24208079535","NEO\/POLY\/DEX","OIN 0.1% OP","4","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","61314030802","AZELASTINE","DRO 0.0005","6","Select","Select",""],["","00378668999","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","23155013301","DOXYCYC","TAB 50MG","30","Select","Select",""],["","60505612902","BUDESONIDE","SUS 32MCG","8","Select","Select",""],["","63824007236","MUCINEX","TAB 60-1200","28","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","20","Select","Select",""],["","00713063415","MOMETASONE","CRE 0.001","15","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","15","Select","Select",""],["","68382091634","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","10","Select","Select",""],["","00363010412","PAIN","TAB 325MG","30","Select","Select",""],["","11917017229","NICOTINE","DIS 14MG\/24H","28","Select","Select",""],["","58602000739","OLOPATADINE","SOL 0.002","5","Select","Select",""],["","11917022048","EYE","SOL ITCH REL","5","Select","Select",""],["","50580072636","ZYRTEC","TAB 10MG","30","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":""}]}]}