{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   AIHTNYCDROFWARC E","gend":1,"add":"MIM 361TS ASO","city":"DANVILLE","state":"VA","zip":"24541-9998","dob":"1962-06-15","age":"","mstatus":"","insh":"98500210*81","cliId":"","pno":"97\/4348301-3","cno":"","email":"","ename":"","eno":"","pphy":"DOLAN, FRANK 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":"OHCC","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":["G47.33","F33.1","F41.1","M51.26","M54.5","M51.36","Z95.810","C50.011","I25.5","R06.02","I25.10","I42.8","E78.5","E11.9","I05.9","I10.","I11.9","I49.01","T82.855A","I47.2","I25.82","I11.0","I50.22","E87.6","K21.9","I25.119","L40.0","M54.16","L91.8","L82.1","L82.0","R20.9","R20.8","R23.8","L53.8","L29.8","I49.1","R07.89","R07.9","R00.0","Z45.02","Z23.","I50.9","F32.9","G47.30","Z85.3","Z79.82","H25.13","H52.4","I44.4","F41.9","I49.02","D22.39","L81.3","M54.41","I42.9","N95.0"],"date":["2021-10-19","2021-04-15","2021-04-15","2021-06-22","2021-06-22","2021-06-22","2021-12-02","2020-03-13","2021-11-05","2021-06-27","2021-11-05","2021-10-18","2021-10-20","2021-10-20","2021-10-18","2021-10-25","2021-10-18","2021-10-25","2021-10-25","2021-11-05","2021-10-19","2021-10-19","2021-10-19","2021-10-25","2021-10-19","2021-10-19","2021-09-24","2021-05-19","2021-05-25","2021-05-25","2021-05-25","2021-05-25","2021-05-25","2021-05-25","2021-05-25","2021-05-25","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2021-11-05","2021-02-27","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2021-08-26","2021-08-26","2021-10-19","2021-10-25","2021-10-19","2021-09-24","2021-09-24","2021-02-05","2021-06-10","2021-10-19"],"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":[["","","BUSPIRONE","TAB 7.5MG","","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","90","Select","Select",""],["","","DIAZEPAM"," DIAZEPAM ","50","Select","Select",""],["","","POT  CHLORIDE"," POT  CHLORIDE","30","Select","Select",""],["","","ENTRESTO"," ENTRESTO ","60","Select","Select",""],["","","METOPROL"," METOPROL ","180","Select","Select",""],["","","ALPRAZOLAM"," ALPRAZOLAM ","30","Select","Select",""],["","31722058330","DULOXETINE","CAP 60MG","180","Select","Select",""],["","00378718605","METFORMIN","TAB 850MG","90","Select","Select",""],["","","SERTRALINE"," SERTRALINE ","30","Select","Select",""],["","63646001004","KETOCONAZOLE","SHA 0.02","120","Select","Select",""],["","16729049112","DOFETILIDE","CAP 250MCG","60","Select","Select",""],["","16729022501","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","00472040250","CLOBETASOL","SOL 0.0005","50","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA","100","Select","Select",""],["","","FUROSEMIDE","TAB 40MG","","Select","Select",""],["","50222030260","ENSTILAR","AER ","60","Select","Select",""],["","65162010210","GABAPENTIN","CAP 300MG","81","Select","Select",""],["","00781711735","CALCIPOTRIEN","CRE 0.00005","120","Select","Select",""],["","00832532511","POT  CL MICRO","TAB 20MEQ ER","30","Select","Select",""],["","59762500802","MISOPROSTOL","TAB 200MCG","2","Select","Select",""],["","70700015010","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","00603020922","MAG","TAB 400MG","30","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","65862083030","PRASUGREL","TAB 10MG","30","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","","HYDROXYZ","CAP 25MG","","Select","Select",""],["","","KLOR-CON","TAB 10MEQ ER","","Select","Select",""],["","","FLUCLVX","INJ 2020-21","","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}