{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ELIZABETH   R JAMES","gend":1,"add":"128 STONEWALL RD","city":"NEW CANTON","state":"VA","zip":"23123-9998","dob":"1970-05-17","age":"","mstatus":"","insh":"20029800*01","cliId":"","pno":"","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":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/581-1105","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R39.81","R15.9","I10.","E11.9","Z71.89","Z71.3","E03.9","E78.5","Z12.11","Z11.4","J30.9","Z12.4","Z13.1","H21.541","H26.493","H40.1132","H27.03","H40.1112","H40.1122","H52.13","Z23.","Z00.00","R56.9","G40.909","E87.5","B34.9"],"date":["2021-12-02","2021-12-02","2021-10-05","2021-03-09","2021-03-09","2021-03-09","2021-10-05","2021-10-05","2021-03-09","2020-09-04","2020-09-04","2021-06-09","2021-10-05","2021-10-25","2021-10-25","2021-10-25","2021-04-12","2020-12-28","2020-12-28","2020-12-28","2020-12-04","2021-03-09","2021-10-05","2019-10-28","2019-02-22","2019-02-22"],"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":{"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":[["","","PRAVASTATIN"," PRAVASTATIN ","30","Select","Select",""],["","","BRIMONIDINE"," BRIMONIDINE ","5","Select","Select",""],["","80681013901","CALCIUM\/D3","TAB 600MG","60","Select","Select",""],["","","LORATADINE","TAB 10MG","","Select","Select",""],["","","FEROSUL"," FEROSUL ","60","Select","Select",""],["","","LISINOPRIL"," LISINOPRIL ","30","Select","Select",""],["","","LEVOTHYROXIN"," LEVOTHYROXIN ","30","Select","Select",""],["","","LATANOPROST"," LATANOPROST ","2","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","DIVALPROEX"," DIVALPROEX ","90","Select","Select",""],["","","DORZOL\/TIMOL"," DORZOL\/TIMOL ","10","Select","Select",""],["","","METFORMIN"," METFORMIN ","34","Select","Select",""],["","","CALCIUM\/D"," CALCIUM\/D ","60","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":""}]}]}