{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"A   ADNAMALLERTTOC ","gend":1,"add":"LLIH 2712DAOR EDIS","city":"RINGGOLD","state":"VA","zip":"24586-9998","dob":"1980-02-23","age":"","mstatus":"","insh":"8120110*80","cliId":"","pno":"17\/4341012-0","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":"M4","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":["F15.10","Z00.00","F41.9","F51.01","N76.0","F15.20","K59.00","E55.9","R10.9","R00.2","R52.","G43.011","W57.XXXA","R06.00","Z20.828","R63.5","R19.7","K58.2","R14.0","R09.81","R43.2","U07.1","J06.9","NO DATA","F33.1","S60.051A","S60.031A","W23.0XXA","J01.00","J20.9","H65.92","Z72.0","N13.2","N20.1","R07.9","R94.31"],"date":["2021-06-14","2021-01-29","2021-07-02","2021-01-29","2021-01-29","2020-10-09","2021-07-02","2021-07-02","2021-07-02","2021-12-22","2020-07-30","2020-07-30","2020-07-30","2021-12-22","2021-12-22","2021-12-22","2021-03-12","2021-03-12","2021-03-12","2020-12-10","2020-12-10","2020-12-10","2020-12-17","2020-11-01","2021-02-01","2019-02-10","2019-02-10","2019-02-10","2019-12-31","2019-12-31","2019-12-31","2019-12-31","2019-09-12","2019-09-12","2021-12-22","2021-12-22"],"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":[["","","VENLAFAXINE","CAP 75MG ER","","Select","Select",""],["","","VITAMIN","CAP 50000UNT","","Select","Select",""],["","","TRAZODONE","TAB 50MG","","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","Select","Select",""],["","","DULOXETINE","CAP 60MG","","Select","Select",""],["","","ONDANSETRON","TAB 4MG","","Select","Select",""],["","00054001829","PREDNISONE","TAB 20MG","10","Select","Select",""],["","","BROM\/PSE\/DM","SYP ","","Select","Select",""],["","","CIPROFLOXACN","TAB 500MG","","Select","Select",""],["","","METHOCARBAM","TAB 750MG","","Select","Select",""],["","","HYDROXYZ","TAB 25MG","","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","","NICOTINE","GUM 4MG ORIG","","Select","Select",""],["","","MAG","SOL LEMON","","Select","Select",""],["","","STOOL","CAP 100MG","","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","69543038810","KETOROLAC","TAB 10MG","10","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","14","Select","Select",""],["","59310057922","PROAIR","AER ","8","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":""}]}]}