{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CATHERINE ATKINS","gend":1,"add":"8570 W COURTHOUSE ROAD","city":"BURKEVILLE","state":"VA","zip":"23922-9998","dob":"1958-01-15","age":"","mstatus":"","insh":"20004161*01","cliId":"","pno":"434\/767-3707","cno":"","email":"","ename":"","eno":"","pphy":"BASHORE, RANDALL T MD","ppno":"434\/581-3271","pcpadd":"RT 15 SOUTH","pcpcity":"NEW CANTON","pcpstate":"VA","pcpzip":23123,"pcpcounty":"","pcpid":"","pcpname":"CENTRAL VIRGINIA HEALTH SERVICES INC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/581-1105","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z98.890","Z48.810","Z08.","Z85.42","Z68.41","U07.1","J96.01","E11.9","Z23.","H25.11","Z20.828","M79.605","Z00.00","H25.13","H25.12","R06.02","R05.","R09.02","Z71.89","Z71.3","Z12.11","I82.512","M17.12","J12.89","J44.9","Q07.8","Z09.","Z86.018","H25.9","A41.9","I95.9","D12.2","D12.3","K64.1","E11.49","E03.9","I10.","C50.911","C53.0","R10.13","J45.20","Z96.1","A41.89","NO DATA","J44.0","E78.5","E11.40","Z79.01","Z79.1","Z79.84","Z79.890","Z86.718","Z87.891","Z88.5","Z88.0","C54.1","H52.13","H52.203","H52.4","R42.","R30.0","J45.41","E75.21","Z13.1","F32.9"],"date":["2020-10-01","2020-10-01","2021-06-21","2021-06-21","2020-11-16","2021-03-10","2021-01-05","2021-01-05","2021-12-20","2020-07-31","2020-12-28","2021-06-21","2021-06-21","2020-08-07","2020-08-20","2021-01-02","2021-01-02","2021-01-02","2022-08-08","2022-08-08","2021-03-10","2022-08-08","2021-08-18","2021-01-02","2021-10-01","2020-06-19","2020-11-18","2020-11-18","2020-07-20","2021-01-03","2021-01-03","2021-02-22","2021-02-22","2021-02-22","2022-08-08","2022-08-08","2022-08-08","2021-03-10","2021-03-10","2021-12-20","2020-03-11","2020-10-01","2021-01-02","2021-01-02","2021-01-02","2021-01-02","2021-01-02","2021-01-02","2021-01-02","2021-01-02","2021-01-02","2021-01-02","2021-01-02","2021-01-02","2021-01-02","2019-11-11","2019-06-18","2019-06-18","2019-06-18","2019-03-20","2019-03-20","2019-05-20","2022-08-08","2022-08-08","2022-08-08"],"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":[["","43547038450","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","68382005101","MELOXICAM","TAB 15MG","30","Select","Select",""],["","68382004110","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","00378265010","AMITRIPTYLIN","TAB 50MG","30","Select","Select",""],["","51991074710","DULOXETINE","CAP 30MG","30","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","68462019605","PRAVASTATIN","TAB 20MG","30","Select","Select",""],["","50458057990","XARELTO","TAB 20MG","30","Select","Select",""],["","53746017810","METFORMIN","TAB 500MG ER","30","Select","Select",""],["","00781279010","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","00781518410","LEVOTHYROXIN","TAB 100MCG","30","Select","Select",""],["","50111078710","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00054001829","PREDNISONE","TAB 20MG","7","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","00054418625","DEXAMETHASON","TAB 6MG","3","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","42806031250","DOXYCYCL","TAB 100MG","14","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","","BREO","INH 200-25","","Select","Select",""],["","","LANCETS","MIS 30G","","Select","Select",""],["","","GNP","TAB SVR","","Select","Select",""],["","00378827052","ALBUTEROL","NEB 0.00083","75","Select","Select",""],["","00085113204","PROVENTIL","AER HFA","7","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","30","Select","Select",""],["","65162044110","MECLIZINE","TAB 12.5MG","30","Select","Select",""],["","00472032126","HYDROCORT","CRE 0.01","28","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":""}]}]}