{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LARINALE   T ADAMS","gend":0,"add":"1045 DRYBREAD ROAD","city":"EMPORIA","state":"VA","zip":"23847-9998","dob":"1984-07-24","age":"","mstatus":"","insh":"20022877*01","cliId":"","pno":"434\/594-9882","cno":"","email":"","ename":"","eno":"","pphy":"MARCELIN, FITZGERALD MD","ppno":"434\/634-7723","pcpadd":"510 NORTH MAIN STREET","pcpcity":"EMPORIA","pcpstate":"VA","pcpzip":23847,"pcpcounty":"","pcpid":"","pcpname":"SOUTHERN DOMINION HEALTH SYSTEM INC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","I10.","E78.2","J45.30","R10.9","E66.9","R21.","F32.9","F10.19","R30.0","M79.642","F33.2","B35.3","R55.","Z68.31","M62.830","V49.50XA","Z68.30","F17.200","Z68.32"],"date":["2020-09-08","2020-08-13","2020-08-13","2020-08-13","2020-08-13","2020-08-13","2020-08-13","2020-08-13","2020-09-08","2020-02-28","2020-02-28","2020-01-07","2019-06-11","2019-06-11","2019-06-11","2019-07-02","2019-07-02","2019-07-02","2019-01-24","2019-01-24"],"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":[["","","OMEPRAZOLE","CAP 20MG DR","","Select","Select",""],["","68645056854","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","","VENTOLIN","AER ","","Select","Select",""],["","16714089803","LORATADINE","TAB 10MG","30","Select","Select",""],["","","QUETIAPINE","TAB 50MG","","Select","Select",""],["","68645055854","LISINOP\/HCTZ","TAB 20-25MG","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","50111043301","TRAZODONE","TAB 50MG","30","Select","Select",""],["","68645057154","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","","SYMBICORT","AER 160-4.5","","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00067611730","ALLERGY","TAB 10MG","30","Select","Select",""],["","","BUDES\/FORMOT","AER 160-4.5","","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","","TRIAMCINOLON","CRE 0.001","","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00173069700","ADVAIR","AER 500\/50","60","Select","Select",""],["","66993058697","FLUTIC\/SALME","AER 500\/50","60","Select","Select",""],["","00168009915","KETOCONAZOLE","CRE 0.02","15","Select","Select",""],["","00536407601","NIACIN","TAB 100MG","90","Select","Select",""],["","45802017453","MUSCLE","CRE ","85","Select","Select",""],["","10702000709","CYCLOBENZAPR","TAB 10MG","10","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","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":""}]}]}