{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KENNETH GRAY","gend":0,"add":"231 BROOK ST","city":"TAZEWELL","state":"VA","zip":"24651-9998","dob":"1991-03-19","age":"","mstatus":"","insh":"20028152*01","cliId":"","pno":"304\/308-8007","cno":"","email":"","ename":"","eno":"","pphy":"KNISELY, THOMAS DO","ppno":"540\/427-9200","pcpadd":"2145 MT PLEASANT BLVD","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":24014,"pcpcounty":"","pcpid":"","pcpname":"Radford Student Health Center","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/427-3237","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R11.2","K08.89","J02.9","J40.","M62.838","M25.50","R12.","J30.2","J30.89","R07.1","K04.7","M25.512","H10.45","H11.153","F17.200","R03.0","H65.01","F17.210","J01.90","R05.","H66.002","Z13.1","Z13.220","Z13.29","R73.9","R79.89","E05.90","K02.9","F17.290","F33.1","M79.601","M79.602","M54.5","S46.912A","R30.0","R10.32","M54.42","K21.9","M62.830"],"date":["2019-02-19","2021-06-22","2021-03-03","2019-10-25","2021-07-08","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2021-07-08","2019-03-17","2021-03-03","2021-09-23","2021-09-23","2021-09-23","2021-09-23","2021-10-11","2021-10-11","2019-07-22","2019-07-22","2019-07-22","2020-09-17","2020-09-17","2020-09-17","2021-03-03","2021-03-03","2021-03-03","2021-06-22","2021-06-22","2019-10-31","2019-01-14","2019-01-14","2021-04-05","2020-08-25","2021-04-05","2021-04-05","2021-04-19","2019-02-21","2021-05-17"],"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":[["","","IBUPROFEN"," IBUPROFEN ","40","Select","Select",""],["","","METHYLPRED"," METHYLPRED ","21","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","20","Select","Select",""],["","00832105410","BACLOFEN","TAB 10MG","15","Select","Select",""],["","65862086001","FAMOTIDINE","TAB 40MG","30","Select","Select",""],["","","AMOXICILLIN"," AMOXICILLIN ","30","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","CYCLOBENZAPR","TAB 5MG","","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","","ORPHENADRINE","TAB 100MG ER","","Select","Select",""],["","","LORATADINE","TAB 10MG","","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":""}]}]}