{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOSEPH   L LANGER","gend":0,"add":"PATRICIA LOYOLA","city":"WINCHESTER","state":"VA","zip":"22604-9998","dob":"1960-12-05","age":"","mstatus":"","insh":"20030874*01","cliId":"","pno":"814\/312-7873","cno":"","email":"","ename":"","eno":"","pphy":"DENNIS, TIFFANI D MD","ppno":"434\/654-8930","pcpadd":"590 PETER JEFFERSON PKWY SUITE 100","pcpcity":"CHARLOTTESVILLE","pcpstate":"VA","pcpzip":22911,"pcpcounty":"","pcpid":"","pcpname":"SMJMG - Sentara Martha Jefferson Internal Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/654-8931","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F10.129","A41.9","J69.0","J96.01","R65.21","K29.21","E87.2","I24.8","J44.1","K81.0","S22.49XA","D64.9","F10.229","D69.59","E83.42","E86.0","E87.6","F17.210","V58.89","I10.","J44.9","I25.10","Z86.718","Z79.01","Z79.51","Z79.899","Z53.29","Z48.02","R07.9","I46.9","F10.920","R53.1","F10.20","I42.6","F10.10","F10.120","I73.9","F41.9","R07.89","Z90.81","Z79.82","Z89.412","Z89.421","Z81.1","Z59.0","F10.220","E78.00","J40.","R07.81","I50.22","I43.","G89.4","I11.0","I25.118","I25.2","S01.81XA","R40.20","R06.02","Z76.0","Z86.711","Z53.21"],"date":["2020-04-30","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-06-28","2020-06-28","2020-06-28","2020-06-28","2020-06-28","2020-06-28","2020-06-28","2020-06-28","2020-06-28","2020-06-28","2020-06-04","2020-10-17","2019-02-08","2019-02-09","2019-06-24","2019-07-06","2019-02-08","2019-07-10","2019-07-06","2019-09-27","2019-07-06","2019-06-24","2019-07-06","2019-09-27","2019-09-27","2019-06-24","2019-06-24","2019-02-08","2019-02-08","2019-03-11","2019-03-11","2019-07-06","2019-07-06","2019-07-06","2019-07-06","2019-07-06","2019-07-06","2019-07-16","2019-09-27","2019-03-25","2019-03-25","2019-03-25","2019-09-27"],"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":[["","68001033508","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","87701040731","GNP","TAB 500MCG","15","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","45963055650","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","43547025110","CHLORDIAZEP","CAP 5MG","15","Select","Select",""],["","00143973910","PREDNISONE","TAB 10MG","38","Select","Select",""],["","68382005005","MELOXICAM","TAB 7.5MG","15","Select","Select",""],["","57896091136","ASPIRIN","CHW 81MG","30","Select","Select",""],["","59746021605","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","00173071720","ADVAIR","AER 230\/21","12","Select","Select",""],["","69315012710","FOLIC","TAB 1000MCG","30","Select","Select",""],["","65862019299","FLUOXETINE","CAP 10MG","30","Select","Select",""],["","68382080510","TRAZODONE","TAB 50MG","30","Select","Select",""],["","50742061510","METOPROL","TAB 25MG ER","30","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","60505258009","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","00003089321","ELIQUIS","TAB 2.5MG","60","Select","Select",""],["","00054429931","FUROSEMIDE","TAB 40MG","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":""}]}]}