{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SARAH LAWRENCE","gend":1,"add":"NA NA                                                       ","city":"NA                            ","state":"VA","zip":"12345-9998","dob":"1992-05-08","age":"","mstatus":"","insh":6823994,"cliId":"","pno":5404963641,"cno":5404923641,"email":"","ename":"","eno":"","pphy":"COX, BRANDON K                                              ","ppno":5402977181,"pcpadd":"1613 Oakwood St                                             ,Ste 101                                                     ","pcpcity":"Bedford                       ","pcpstate":"VA","pcpzip":245231213,"pcpcounty":"","pcpid":"","pcpname":"CENTRA MEDICAL GROUP","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"","aligned":"","ano":"","add2":"NA NA                                                       ","add3":"","madd1":"NA NA                                                       ","madd2":"                                                            ","madd3":"","mcity":"NA                            ","mstate":"VA","mzip":"12345-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","J98.8","Z72.0","Z30.9","Z01.419","H66.91","H61.21","J30.9","K08.89","L02.416","F15.20","F12.20","F31.9","Z79.899","Z30.40","A41.9","K72.00","D69.6","E87.1","E87.6","F17.210","F15.10","A93.8","R65.20","M54.5","Z88.8","Z80.1","R10.9","M41.9","M54.9","M47.816","N87.1","N87.9","F90.9","F32.9","F41.9","K21.9","D06.9","Z30.42","S46.819A","G47.00","S93.402A","W01.0XXA","Y93.01","S99.912A","S93.409A","Z32.01"],"date":["2020-01-29","2020-02-26","2020-05-27","2022-11-14","2020-03-05","2020-05-27","2020-05-27","2020-05-27","2020-11-03","2020-11-03","2021-07-23","2021-07-23","2021-06-29","2021-07-23","2021-12-02","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2019-04-02","2019-04-02","2019-04-02","2019-04-25","2019-09-05","2019-04-02","2019-04-03","2019-12-11","2019-04-10","2019-10-17","2019-07-06","2019-07-06","2019-07-06","2019-07-06","2019-07-09","2019-12-11"],"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":[["","42806031250","DOXYCYCL","TAB 100MG","20","Select","Select",""],["","29300011101","LAMOTRIGINE","TAB 25MG","30","Select","Select",""],["","63402030230","LATUDA","TAB 20MG","30","Select","Select",""],["","00406117003","NALTREXONE","TAB 50MG","2","Select","Select",""],["","13668021930","ARIPIPRAZOLE","TAB 15MG","30","Select","Select",""],["","65862019430","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","00703680101","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","16729044315","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","57237004101","PENICILLN","TAB 500MG","56","Select","Select",""],["","50383077504","LIDOCAINE","SOL 2% VISC","100","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","20","Select","Select",""],["","13107003134","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","00054001729","PREDNISONE","TAB 10MG","20","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","15","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","10","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":""}]}]}