{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   ARATSNAVE J","gend":1,"add":"INAHCEM 9416EKPT ELLIVSC","city":"MECHANICSVILLE","state":"VA","zip":"23111-9998","dob":"1981-07-16","age":"","mstatus":"","insh":"98500210*65","cliId":"","pno":"26\/4083640-5","cno":"804\/625-0463","email":"","ename":"","eno":"","pphy":"GOODWIN, MARIE I NP","ppno":"434\/738-6420","pcpadd":"380 WASHINGTON STREET","pcpcity":"BOYDTON","pcpstate":"VA","pcpzip":23917,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","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":["F43.10","F39.","F15.90","F33.2","H66.93","K08.89","Z20.828","Z76.0","K02.9","I10.","J45.909","F17.210","F31.2","F10.10","F31.13","F43.12","F11.10","F12.10","Z03.818","F14.14","F33.1","N91.2","Z32.02","F31.9","M25.512","H10.45","F31.81","F90.2","F31.32","R44.3","V62.84","R68.89","F33.9","F41.1","R10.31","M79.622","Z74.3","F12.20","F14.20","J30.9","Z01.419","Z12.72"],"date":["2021-07-21","2020-07-26","2020-02-20","2022-05-04","2020-11-24","2021-05-06","2020-11-24","2021-05-06","2021-05-06","2021-05-11","2021-05-06","2021-05-06","2021-06-17","2021-06-17","2022-05-24","2022-05-24","2020-02-28","2020-02-28","2020-07-25","2020-07-25","2022-05-24","2021-06-28","2021-06-28","2022-07-13","2020-02-14","2021-05-11","2021-07-21","2022-05-15","2022-07-20","2020-02-15","2020-02-15","2020-07-25","2022-07-07","2021-07-21","2020-12-21","2020-02-14","2020-02-14","2021-07-25","2021-07-25","2021-10-19","2021-05-17","2021-05-17"],"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":[["","58602044509","ALLERGY","TAB 10MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","65862052305","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","16714008310","HYDROXYZ","TAB 50MG","270","Select","Select",""],["","45802008801","ALBUTEROL","AER HFA","8","Select","Select",""],["","00472016630","NYSTATIN","OIN 100000","30","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","90","Select","Select",""],["","11845009611","MAGNESIUM","TAB 200MG","90","Select","Select",""],["","13668001990","VENLAFAXINE","CAP 75MG ER","90","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","65862066330","ARIPIPRAZOLE","TAB 10MG","30","Select","Select",""],["","00093406801","PRAZOSIN","CAP 2MG","90","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","2","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","72618300002","NURTEC","TAB 75MG ODT","8","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","65162068210","PHENAZOPYRID","TAB 200MG","6","Select","Select",""],["","31722054501","LITHIUM","CAP 300MG","90","Select","Select",""],["","57237004101","PENICILLN","TAB 500MG","28","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","63402030430","LATUDA","TAB 40MG","90","Select","Select",""],["","66993068130","OLANZAPINE","TAB 5MG","30","Select","Select",""],["","68382011414","RISPERIDONE","TAB 1MG","30","Select","Select",""],["","65862052201","NAPROXEN","TAB 500MG","20","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","90","Select","Select",""],["","70000020101","ALL","TAB 220MG","90","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","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":""}]}]}