{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DARREN   D HARDY","gend":0,"add":"504 PARK ST","city":"LAWRENCEVILLE","state":"VA","zip":"23868-9998","dob":"1964-12-14","age":"","mstatus":"","insh":"20028599*01","cliId":"","pno":"434\/378-1553","cno":"434\/378-1553","email":"","ename":"","eno":"","pphy":"ACKERMAN, CHRISTOPHER J MD","ppno":"434\/848-0771","pcpadd":"203 SHARP ST","pcpcity":"LAWRENCEVILLE","pcpstate":"VA","pcpzip":23868,"pcpcounty":"","pcpid":104888,"pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"434\/604-6051","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/848-3814","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M46.46","M46.26","NO DATA","M40.14","N17.9","E88.2","I10.","E11.69","B19.20","F10.10","G89.18","R11.2","Z74.09","K74.69","F41.9","Z79.899","K59.00","Z79.82","M54.9","I11.9","Z45.2","A40.9","Z79.2","K70.30","R94.5","M46.40","E11.9","K74.60","M46.20","G06.1","M54.16","D50.9","Z47.89","M51.16","A40.8","K68.12","I12.9","E11.22","N18.3","J18.9","V54.17","D63.1","J11.1","D64.9","M51.06","M62.81","K21.9","G47.00","F10.20","E66.9","L76.32","M51.36","G82.20","R07.9","R03.0","M46.30","N18.9","K70.9","F19.10","F32.9","M54.5","Z98.1"],"date":["2020-03-03","2020-03-05","2020-03-05","2020-01-24","2020-01-24","2020-01-24","2020-02-01","2020-03-05","2020-01-24","2020-03-03","2020-01-26","2020-01-24","2020-01-24","2020-01-24","2020-03-03","2020-01-28","2020-01-31","2020-01-24","2020-02-06","2021-02-22","2020-03-03","2020-03-03","2020-03-03","2021-02-22","2020-03-03","2020-01-03","2020-05-12","2020-01-31","2020-01-28","2020-01-28","2020-02-04","2020-02-10","2020-03-05","2020-03-05","2020-03-05","2020-03-05","2020-03-05","2020-03-05","2020-03-05","2020-03-05","2020-03-05","2020-03-05","2020-02-24","2020-02-07","2020-01-31","2020-01-31","2020-01-31","2020-01-31","2020-11-10","2020-01-02","2020-02-07","2020-03-04","2020-01-27","2020-10-04","2020-10-04","2020-05-12","2020-02-01","2020-10-04","2020-10-04","2020-10-05","2020-01-07","2020-02-18"],"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":[["","00093078701","ATENOLOL ","25MG","60","Select","Select",""],["","43547035410","LISINOPRIL ","20MG","60","Select","Select",""],["","13107005501","OXYCODONE ","5MG","28","Select","Select",""],["","11822353540","RA ","","510","Select","Select",""],["","31722063231","OSELTAMIVIR ","75MG","10","Select","Select",""],["","67877019805","AMLODIPINE ","5MG","30","Select","Select",""],["","59746017206","PREDNISONE ","5MG","7","Select","Select",""],["","00093310953","AMOXICILLIN ","500MG","90","Select","Select",""],["","65162046510","IBUPROFEN ","600MG","120","Select","Select",""],["","70010075401","METHOCARBAM ","500MG","60","Select","Select",""],["","10939075444","CALCIUM+D3 ","600-800","60","Select","Select",""],["","13107005501","OXYCODONE","5MG","28","Select","Select",""],["","11822353540","RA","","510","Select","Select",""],["","00093078701","ATENOLOL","25MG","30","Select","Select",""],["","43547035410","LISINOPRIL","20MG","30","Select","Select",""],["","57237002801","AMOXICILLIN","500MG","84","Select","Select",""],["","67877019805","AMLODIPINE","5MG","30","Select","Select",""],["","59746017206","PREDNISONE","5MG","7","Select","Select",""],["","31722063231","OSELTAMIVIR","75MG","10","Select","Select",""],["","65162046510","IBUPROFEN","600MG","30","Select","Select",""],["","70010075401","METHOCARBAM","500MG","60","Select","Select",""],["","10939075444","CALCIUM+D3","600-800","60","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":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","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":""}]}]}