{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JULIE HOLT","gend":1,"add":"248 BRIGHTWELL CT","city":"DANVILLE","state":"VA","zip":24540,"dob":"1976-10-13","age":"","mstatus":"","insh":"1204702*01","cliId":"","pno":"434\/709-0444","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"434\/835-4876","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":24540,"pcpcounty":"","pcpid":"","pcpname":"GO DOCS","plan":"OHP","program":"Medicaid","lob":"M4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/835-4875","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.9","E11.9","R94.5","R79.0","R77.8","N95.9","F41.1","F33.2","G47.00","E78.5","E55.9","F41.9","F32.9","F39.","F60.9","M54.5","R74.8","D64.9","Z03.818","Z20.828","G25.81","N92.0","G47.30","E66.9","Z51.81","I10.","R11.0","E78.2","E53.8","R63.5","R53.83","R73.09","R03.0","Z20.822","Z68.31","B34.8","R05.8"],"date":["2021-03-16","2022-07-25","2021-03-16","2021-03-16","2021-03-16","2021-03-16","2021-03-16","2021-03-16","2022-07-25","2022-07-25","2022-07-25","2022-07-25","2022-07-25","2022-07-25","2022-07-25","2021-03-16","2020-09-16","2022-07-25","2021-01-02","2021-01-02","2022-07-25","2021-09-20","2020-01-07","2022-07-25","2022-07-25","2019-10-07","2019-04-11","2019-01-14","2019-01-14","2019-01-14","2019-01-14","2019-01-14","2022-01-22","2022-11-13","2022-01-22","2022-11-13","2022-11-13"],"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":[["","43547034206","RISPERIDONE","TAB 2MG","30","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","00093727198","PIOGLITAZONE","TAB 15MG","30","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","55111032101","GLIMEPIRIDE","TAB 2MG","60","Select","Select",""],["","69097083512","SERTRALINE","TAB 100MG","60","Select","Select",""],["","00006027731","JANUVIA","TAB 100MG","30","Select","Select",""],["","70436001002","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","65862049101","QUETIAPINE","TAB 100MG","30","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","69238126601","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","75834002001","VITAMIN","CAP 50000UNT","8","Select","Select",""],["","51991081403","AZELASTINE","SPR 0.001","30","Select","Select",""],["","53885059501","ONETOUCH","MIS 30G","100","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":{"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":""}]}]}