{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RHONDA JOLLY","gend":1,"add":"505 MILES AVE","city":"HOPEWELL","state":"VA","zip":"23860-9998","dob":"1978-02-09","age":"","mstatus":"","insh":"1219772*01","cliId":"","pno":"804\/324-0450","cno":"804\/248-4872","email":"","ename":"","eno":"","pphy":"GADANI, MANU R MD","ppno":"804\/458-2006","pcpadd":"SUITE 101 5303 PLAZA DRIVE","pcpcity":"HOPEWELL","pcpstate":"VA","pcpzip":23860,"pcpcounty":"","pcpid":"","pcpname":"MANU R GADANI MD PC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/458-3629","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["V58.89","S32.425A","S22.32XA","V54.13","V54.19","F32.9","F90.9","S32.492A","M62.81","S06.0X0A","S32.422A","R10.84","F90.0","S32.402A","F17.200","S61.214A","Z82.49","Z88.1","R07.89","T14.8XXA","Z47.89","R10.11","S51.012A","S80.02XA","M25.552","Z00.00","R06.02","R53.1","R53.83"],"date":["2020-02-10","2020-01-11","2020-02-12","2020-02-12","2020-02-10","2020-02-10","2020-02-10","2020-02-10","2020-02-10","2020-01-10","2020-01-10","2020-01-10","2020-09-08","2020-01-10","2020-01-10","2020-01-10","2020-01-10","2020-01-10","2020-01-10","2020-01-10","2020-02-12","2020-01-10","2020-01-10","2020-09-13","2020-09-13","2019-04-23","2019-04-23","2019-04-23","2019-04-23"],"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":[["","59267100003","PFIZER","INJ COVID-19","0","Select","Select",""],["","00006483703","PNEUMOVAX","INJ 25\/0.5","0","Select","Select",""],["","","TRAZODONE","TAB 50MG","","Select","Select",""],["","","OXYCODONE","TAB 5MG","","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","43547034850","PAROXETINE","TAB 20MG","30","Select","Select",""],["","68382095501","AMPHET\/DEXTR","TAB 20MG","60","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","Select","Select",""],["","","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","","ZOLPIDEM","TAB 5MG","","Select","Select",""],["","","MAPAP","TAB 500MG","","Select","Select",""],["","","LIDOCAINE","PAD 0.05","","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","","ADDERALL","TAB 20MG","","Select","Select",""],["","65862019399","FLUOXETINE","CAP 20MG","30","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":""}]}]}