{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RODNEY   L LAWSON","gend":0,"add":"639 SPENCER RD","city":"CONCORD","state":"VA","zip":"24538-9998","dob":"1960-03-21","age":"","mstatus":"","insh":"1736037*01","cliId":"","pno":"434\/993-3366","cno":"434\/993-3366","email":"","ename":"","eno":"","pphy":"PHYSICIAN, PRIMARY CARE (MISC)","ppno":"","pcpadd":"4417 CORPORATION LN","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23462,"pcpcounty":"","pcpid":799999,"pcpname":"","plan":"OHP","program":"ACA","lob":"Small Group","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"434\/610-0958","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":["R05.","R06.02","R50.9","G47.33","R06.00","U07.1","J45.909","Q25.79","Z28.21","J30.9","R23.8","Z12.11","D12.3","K64.8","Q21.1","G47.30","I10.","Z20.828","J20.9","J32.9","K21.9","J84.10","J98.4","R94.2","I27.20","Q33.6","Z79.82","Z20.822","I08.0"],"date":["2020-12-21","2021-07-06","2020-03-23","2021-07-06","2021-06-17","2021-03-09","2021-07-06","2021-05-10","2020-02-10","2021-02-03","2020-05-27","2021-03-22","2021-03-22","2021-03-22","2021-07-06","2021-05-18","2021-07-06","2021-05-18","2020-02-26","2021-02-17","2021-07-06","2020-03-23","2020-03-23","2021-02-03","2021-07-06","2021-07-06","2021-07-06","2021-06-30","2021-07-06"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"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":[]}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","00173069600","ADVAIR","250\/50","60","Select","Select",""],["","00378932232","WIXELA","500\/50","60","Select","Select",""],["","59310057922","PROAIR","","8","Select","Select",""],["","00093742698","MONTELUKAST","10MG","30","Select","Select",""],["","68180016013","AZITHROMYCIN","250MG","1","Select","Select",""],["","69315030805","CIPROFLOXACN","0.3% OP","5","Select","Select",""],["","00378827052","ALBUTEROL","0.08%","1575","Select","Select",""],["","00378064205","PREDNISONE","20MG","14","Select","Select",""],["","00093083205","CLONAZEPAM","0.5MG","1","Select","Select",""],["","62175061743","PANTOPRAZOLE","40MG","90","Select","Select",""],["","52268001201","SUPREP","PREP KIT","-354","Select","Select",""],["","00173088210","BREO","200-25","-60","Select","Select",""],["","66993058597","FLUTIC\/SALME","250\/50","60","Select","Select",""],["","69315011601","FUROSEMIDE","20MG","30","Select","Select",""],["","00143980305","DOXYCYCL","100MG","14","Select","Select",""],["","65862050320","AMOX\/K","875-125","14","Select","Select",""],["","60432060616","PROMETH\/COD","6.25-10","180","Select","Select",""],["","24208050707","LOTEMAX","0.38%","5","Select","Select",""],["","68180071160","CEFDINIR","300MG","40","Select","Select",""],["","51224000160","BENZONATATE","200MG","30","Select","Select",""],["","59310057922","PROAIR ","","8","Select","Select",""],["","76204020060","ALBUTEROL ","0.08%","360","Select","Select",""],["","69315011601","FUROSEMIDE ","20MG","30","Select","Select",""],["","00378932232","WIXELA ","500\/50","60","Select","Select",""],["","00173088210","BREO ","200-25","-180","Select","Select",""],["","68180016013","AZITHROMYCIN ","250MG","1","Select","Select",""],["","52817029590","SILDENAFIL ","20MG","90","Select","Select",""],["","00054001825","PREDNISONE ","20MG","14","Select","Select",""],["","00143980305","DOXYCYCL ","100MG","14","Select","Select",""],["","00173069600","ADVAIR ","250\/50","-60","Select","Select",""],["","62175061743","PANTOPRAZOLE ","40MG","-30","Select","Select",""],["","00093742698","MONTELUKAST ","10MG","30","Select","Select",""],["","65862050320","AMOX\/K ","875-125","14","Select","Select",""],["","68180071160","CEFDINIR ","300MG","40","Select","Select",""],["","00093083205","CLONAZEPAM ","0.5MG","1","Select","Select",""],["","52268001201","SUPREP ","PREP KIT","-354","Select","Select",""],["","66993058597","FLUTIC\/SALME ","250\/50","60","Select","Select",""],["","60432060616","PROMETH\/COD ","6.25-10","180","Select","Select",""],["","17478071410","CIPROFLOXACN ","0.3% OP","5","Select","Select",""],["","24208050707","LOTEMAX ","0.38%","5","Select","Select",""],["","51224000160","BENZONATATE ","200MG","30","Select","Select",""],["","68001036305","SILDENAFIL","20MG","90","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}