{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HTEBAZILEDRUH P   ","gend":1,"add":"TUH 6652DAOR NOS","city":"DRY FORK","state":"VA","zip":"24549-9998","dob":"1982-11-07","age":"","mstatus":"","insh":"9054110*36","cliId":"","pno":"27\/4344056-4","cno":"","email":"","ename":"","eno":"","pphy":"ARROYO, DEIRDRE F NP","ppno":"434\/791-4122","pcpadd":"705 MAIN STREET","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"PIEDMONT ACCESS TO HEALTH SERVICES INC","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":["M79.661","V58.89","Z01.818","Z11.59","M67.88","M79.671","M25.571","R26.89","E55.9","I10.","F31.70","E11.9","E78.2","F31.30","F41.1","M79.A21","E66.01","J06.9","Z20.822","M54.5","M62.89","M62.831","T79.A21A","L71.8","Q82.8","Z08.","Z85.828","R73.03","R07.2","R05.","D23.72","D23.71","D48.5","H52.6","G93.2","M79.672"],"date":["2020-09-04","2020-09-04","2020-07-16","2020-07-16","2021-12-14","2021-12-10","2021-12-14","2020-09-04","2020-11-09","2020-11-09","2020-11-09","2020-11-09","2020-11-09","2021-08-06","2021-08-06","2020-07-21","2020-07-21","2021-08-08","2021-08-08","2020-01-01","2020-07-21","2020-04-27","2020-04-27","2020-05-12","2020-05-12","2020-05-12","2020-05-12","2020-01-15","2020-02-11","2021-05-09","2019-08-22","2019-08-22","2019-08-22","2019-10-10","2019-10-10","2019-11-11"],"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":[["","43547035311","LISINOPRIL","TAB 10MG","90","Select","Select",""],["","54092038301","ADDERALL","CAP 10MG","60","Select","Select",""],["","13668021890","ARIPIPRAZOLE","TAB 10MG","30","Select","Select",""],["","16729004617","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","240","Select","Select",""],["","65862069790","VENLAFAXINE","CAP 150MG ER","30","Select","Select",""],["","64980020501","LITHIUM","TAB 300MG ER","120","Select","Select",""],["","62756018388","OXCARBAZEPIN","TAB 150MG","120","Select","Select",""],["","43975027810","AMPHET\/DEXTR","CAP 10MG ER","60","Select","Select",""],["","00555901658","SPRINTEC","TAB 28 DAY","28","Select","Select",""],["","00603533831","PREDNISONE","PAK 10MG","48","Select","Select",""],["","70010049110","METFORMIN","TAB 500MG ER","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}