{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHADEA   D BATTLE","gend":1,"add":"420 S 21ST AVE APT 24","city":"HOPEWELL","state":"VA","zip":"23860-9998","dob":"1987-06-23","age":"","mstatus":"","insh":"20044607*01","cliId":"","pno":"434\/736-2622","cno":"434\/736-2622","email":"","ename":"","eno":"","pphy":"HOLLAND JR, JOHN A MD","ppno":"434\/696-2165","pcpadd":"1508 K V ROAD","pcpcity":"VICTORIA","pcpstate":"VA","pcpzip":23974,"pcpcounty":"","pcpid":670645,"pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/696-1557","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["T85.611A","N18.6","I12.0","D63.1","E87.5","I16.1","R11.2","I10.","N25.0","R10.9","N39.0","K65.2","R10.2","A59.9","N94.6","N94.10","I16.0","R11.10","M32.9","A54.9","A59.01","Z20.828","N25.81","E83.39","Z88.0","Z88.5","F41.8","Z82.49","Z99.2","L29.9","E87.2","I25.2","F12.20","F17.210","K21.9","F41.9","T40.7X1A","R91.1","R06.02","E87.70","I25.10","D53.9","M32.14","J90.","Z91.15","Z91.14","Z20.822","D72.825","R10.84","R91.8","G62.9","Z86.718","Z79.4","R94.31","I49.9","J96.01","D68.62","I12.9","G47.00","E66.9","Z68.31","D72.0","Z68.27","T85.691A","R07.89","N17.9","K85.90","Z91.19","NO DATA","Z87.442","A41.9","D63.8","Z79.899","Z72.0","R10.30","D50.9","E87.6","R06.03","R06.82","R09.02","R79.89","E16.2","J18.9","T82.898A","T82.858A","I77.1","I13.2","G89.4","F32.9","J80.","J81.0","R10.0","I87.1"],"date":["2020-06-20","2021-09-06","2021-09-06","2021-09-06","2021-09-06","2021-09-06","2021-05-05","2021-09-06","2021-09-06","2021-05-04","2021-04-22","2021-04-21","2021-05-25","2021-04-22","2021-05-25","2021-05-25","2021-05-05","2021-05-04","2021-05-05","2021-05-25","2021-05-25","2020-06-17","2021-09-06","2021-09-06","2021-05-05","2021-01-05","2020-06-17","2020-08-17","2021-09-06","2020-06-17","2021-01-05","2020-08-17","2020-08-17","2021-02-15","2020-08-17","2021-09-06","2020-08-17","2020-08-17","2021-09-06","2021-04-16","2021-02-17","2021-02-17","2021-02-17","2021-02-16","2021-04-16","2021-02-16","2021-09-06","2021-04-17","2021-05-04","2021-02-15","2021-02-15","2021-02-15","2021-02-15","2021-05-05","2021-02-14","2021-09-06","2021-02-15","2021-02-15","2021-02-17","2021-02-15","2021-02-15","2021-04-17","2021-04-22","2020-06-16","2020-08-17","2021-01-05","2021-01-05","2021-05-05","2021-01-05","2021-01-05","2021-04-16","2021-04-16","2021-09-06","2021-09-06","2021-04-19","2020-04-03","2021-01-05","2021-02-14","2021-02-14","2021-02-14","2021-02-14","2021-02-14","2021-09-06","2021-11-22","2021-11-22","2021-08-23","2021-11-22","2021-09-06","2021-09-06","2021-02-14","2021-02-14","2021-05-04","2021-11-22"],"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":[["","62175026237","NIFEDIPINE ","90MG ER","30","Select","Select",""],["","00054008826","CALC ","667MG","90","Select","Select",""],["","65162005827","SEVELAMER ","800MG","90","Select","Select",""],["","50111039701","HYDRALAZINE ","100MG","90","Select","Select",""],["","55111015330","ONDANSETRON ","4MG","30","Select","Select",""],["","00591024110","LORAZEPAM ","1MG","90","Select","Select",""],["","13668001001","CITALOPRAM ","20MG","30","Select","Select",""],["","68382080001","LABETALOL ","300MG","90","Select","Select",""],["","60505265301","TRAZODONE ","50MG","30","Select","Select",""],["","29300013701","CLONIDINE ","0.3MG","90","Select","Select",""],["","31722094101","HYDROCO\/APAP ","5-325MG","20","Select","Select",""],["","58468013001","RENVELA ","800MG","240","Select","Select",""],["","70436000704","CINACALCET ","30MG","90","Select","Select",""],["","69784018014","POLYETH ","3350 NF","1","Select","Select",""],["","31722073190","IRBESARTAN ","300MG","30","Select","Select",""],["","69547035302","NARCAN ","","2","Select","Select",""],["","11822453580","ACID ","10MG","30","Select","Select",""],["","11822031650","RA ","100MG","30","Select","Select",""],["","58160084252","BOOSTRIX ","","0","Select","Select",""],["","47469005964","MELATONIN ","10MG CR","30","Select","Select",""],["","60505258009","ATORVASTATIN ","40MG","30","Select","Select",""],["","63304061650","DOXYCYC ","100MG","20","Select","Select",""],["","29300022701","METRONIDAZOL ","500MG","14","Select","Select",""],["","59746017306","PREDNISONE ","10MG","7","Select","Select",""],["","65162005827","SEVELAMER","800MG","90","Select","Select",""],["","58468013001","RENVELA","800MG","240","Select","Select",""],["","29300013701","CLONIDINE","0.3MG","90","Select","Select",""],["","00185011805","LABETALOL","300MG","90","Select","Select",""],["","50111039701","HYDRALAZINE","100MG","90","Select","Select",""],["","62175026237","NIFEDIPINE","90MG ER","30","Select","Select",""],["","00054008826","CALC","667MG","90","Select","Select",""],["","00591024110","LORAZEPAM","1MG","90","Select","Select",""],["","55111015330","ONDANSETRON","4MG","30","Select","Select",""],["","31722073190","IRBESARTAN","300MG","30","Select","Select",""],["","60505265301","TRAZODONE","50MG","30","Select","Select",""],["","13668001001","CITALOPRAM","20MG","30","Select","Select",""],["","70436000704","CINACALCET","30MG","90","Select","Select",""],["","31722094101","HYDROCO\/APAP","5-325MG","20","Select","Select",""],["","69784018014","POLYETH","3350 NF","1","Select","Select",""],["","11822031650","RA","100MG","30","Select","Select",""],["","58160084252","BOOSTRIX","","0","Select","Select",""],["","11822453580","ACID","10MG","30","Select","Select",""],["","63304061650","DOXYCYC","100MG","20","Select","Select",""],["","69547035302","NARCAN","","2","Select","Select",""],["","68180063709","ATORVASTATIN","40MG","30","Select","Select",""],["","29300022701","METRONIDAZOL","500MG","14","Select","Select",""],["","59746017306","PREDNISONE","10MG","7","Select","Select",""],["","47469005964","MELATONIN","10MG CR","30","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","",""],["No","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":""}]}]}