{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"G YORSSAL","gend":0,"add":"HGIH 0011DR TNIOP","city":"SOUTH BOSTON","state":"VA","zip":"24592-9998","dob":"1975-10-02","age":"","mstatus":"","insh":"97200210*50","cliId":"","pno":"57\/4342302-3","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":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R11.0","K29.80","K29.50","K21.0","K44.9","K30.","H35.52","H25.042","H10.45","Z01.812","Z20.822","Z12.11","R94.31","Z01.89","Z83.71","K57.30","K64.8","K85.90","R07.89","R10.9","Z79.899","R63.4","Z72.0","K82.4","Z87.19","F10.10","H25.043","H25.011","H25.012","NO DATA","H25.041","Z72.89","R93.3","H59.031","K21.00","I10.","J30.2","L02.91","K21.9","Z23.","Z96.1","R63.0","H26.493"],"date":["2020-01-22","2020-01-14","2020-01-14","2020-02-05","2020-01-14","2020-01-14","2021-03-03","2020-08-27","2020-11-30","2021-08-17","2021-08-17","2021-08-20","2021-08-17","2021-08-17","2021-08-20","2021-11-10","2021-08-20","2020-01-22","2019-12-19","2019-12-19","2019-12-19","2021-07-07","2021-11-10","2021-11-10","2021-11-10","2021-11-10","2020-06-30","2020-07-30","2020-08-27","2021-11-10","2020-07-30","2020-01-22","2020-01-22","2020-12-30","2021-07-07","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2021-09-08","2020-12-30","2021-09-08","2021-03-03"],"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":[["","","AMLODIPINE"," AMLODIPINE ","30","Select","Select",""],["","","CETIRIZINE"," CETIRIZINE ","30","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","20","Select","Select",""],["","","ONDANSETRON"," ONDANSETRON ","20","Select","Select",""],["","","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","","MOXIFLOXACIN","SOL HCL 0.5%","","Select","Select",""],["","","PREDNISOLONE","SUS 1% OP","","Select","Select",""],["","","DICLOFENAC","SOL 0.1% OP","","Select","Select",""],["","","DUREZOL","EMU 0.0005","","Select","Select",""],["","","ALLERGY","TAB 10MG","","Select","Select",""],["","","CVS","TAB 10MG","","Select","Select",""],["","","MUPIROCIN","OIN 0.02","","Select","Select",""],["","","KETOROLAC","SOL 0.004","","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":""}]}]}