{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RACHEL   N MAYS","gend":1,"add":"121 DOGWOOD ST APT 5","city":"AMHERST","state":"VA","zip":"24521-9998","dob":"1982-08-27","age":"","mstatus":"","insh":"1473101*01","cliId":"","pno":"434\/277-5045","cno":"434\/277-5045","email":"","ename":"","eno":"","pphy":"DAVIS, TABATHA MD","ppno":"434\/263-4000","pcpadd":"4038 THOMAS NELSON HWY","pcpcity":"ARRINGTON","pcpstate":"VA","pcpzip":22922,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/263-4160","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.1","F90.2","F39.","F10.21","NO DATA","F12.20","Z79.899","N64.4","M25.511","M54.2","V58.89","L08.9","S66.222A","M25.642","M25.632","U07.1","R50.81","K59.09","Z01.812","Z20.822","Z20.828","Z98.84","Z86.69","Z13.39","M54.12","S61.012A","F31.60","R63.4","G44.209","R05.1","Z11.52"],"date":["2021-06-23","2021-06-23","2021-02-10","2021-06-23","2021-06-23","2021-06-23","2021-06-23","2020-09-30","2021-06-16","2021-02-10","2021-10-19","2021-08-16","2021-10-19","2021-10-19","2021-10-19","2022-07-12","2022-01-21","2021-06-23","2021-08-25","2021-08-25","2021-08-25","2021-02-10","2021-02-10","2021-02-10","2021-06-16","2021-08-12","2020-01-16","2020-09-15","2021-01-25","2022-07-12","2021-10-22"],"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":[]},{"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":[["","60505025203","TIZANIDINE","TAB 4MG","30","Select","Select",""],["","60505283303","ATOMOXETINE","CAP 40MG","90","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","28","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","88395014110","VITAMIN","CAP 5000UNIT","90","Select","Select",""],["","10370010150","BUPROPN","TAB 150MG XL","90","Select","Select",""],["","31722070430","VALACYCLOVIR","TAB 500MG","90","Select","Select",""],["","65862060230","MODAFINIL","TAB 200MG","90","Select","Select",""],["","00591565810","CYCLOBENZAPR","TAB 10MG","9","Select","Select",""],["","54092038301","ADDERALL","CAP 10MG","30","Select","Select",""],["","00603020922","MAG","TAB 400MG","90","Select","Select",""],["","50428317683","STOOL","CAP 100MG","180","Select","Select",""],["","00228305911","AMPHET\/DEXTR","CAP 10MG ER","30","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","60","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","30","Select","Select",""],["","61874011530","VRAYLAR","CAP 1.5MG","90","Select","Select",""],["","00115166003","PROPRANOLOL","TAB 20MG","60","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","10702001150","HYDROXYZ","TAB 25MG","180","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":""}]}]}