{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"S NHOJSNOMI","gend":0,"add":"DER 4931DR ENOTS","city":"CHILHOWIE","state":"VA","zip":"24319-9998","dob":"1956-04-09","age":"","mstatus":"","insh":"94300210*68","cliId":"","pno":"96\/6721102-8","cno":"276\/698-2011","email":"","ename":"","eno":"","pphy":"LEE, DANE MD","ppno":"276\/619-6128","pcpadd":"24530 FALCON PLACE BLVD STE 102","pcpcity":"ABINGDON","pcpstate":"VA","pcpzip":24211,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","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":["Z51.11","E53.8","C18.0","G62.9","C18.9","R79.89","E78.5","N40.0","M79.675","R91.8","G62.0","S05.02XA","D50.9","R74.8","S81.012A","T45.1X5A","Z01.818","Z20.822","I10.","Z23.","H25.092","H26.9","H27.111","H54.40","N20.0","Z86.39","L27.1","E86.0","R69.","M25.561","M10.9","Z85.038","Z98.0","C18.2","N40.1","F32.9","M19.90","Z79.899","E80.6","Z85.030","E61.1"],"date":["2020-09-24","2021-03-31","2020-09-24","2020-10-05","2022-10-13","2020-10-05","2022-09-07","2021-05-18","2021-09-14","2022-04-14","2022-04-14","2020-05-06","2020-05-14","2020-05-14","2020-07-27","2022-01-12","2022-02-14","2022-02-14","2022-01-25","2021-09-14","2022-07-26","2022-07-26","2022-07-26","2022-07-26","2021-03-31","2020-12-30","2020-01-29","2020-01-14","2020-05-05","2021-06-02","2022-01-25","2022-02-21","2022-02-21","2021-09-30","2021-03-31","2021-03-31","2021-03-31","2021-09-30","2022-04-14","2022-09-07","2020-11-18"],"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":[]},{"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":[["","65162046650","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","43386006019","GAVILYTE-C","SOL ","4000","Select","Select",""],["","80681002500","VITAMIN","TAB 100MG","90","Select","Select",""],["","16714087501","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","16714066201","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","40985027113","B-12","SUB 5000MCG","30","Select","Select",""],["","87701040730","GNP","TAB 100MG","30","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","55111072901","ALLOPURINOL","TAB 100MG","90","Select","Select",""],["","00245053660","CHOLESTYRAM","POW 4GM","60","Select","Select",""],["","59746038406","TERAZOSIN","CAP 2MG","30","Select","Select",""],["","16729007329","CAPECITABINE","TAB 500MG","56","Select","Select",""],["","00904759182","FERROUS","TAB 325MG","60","Select","Select",""],["","17478007035","ERYTHROMYCIN","OIN OP","4","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","Select","Select",""],["","62175044601","PEG","SOL ELECTROL","4000","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":""}]}]}