{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KERRY   A MILLER","gend":1,"add":"20 ENGLEWOOD DR","city":"PALMYRA","state":"VA","zip":"22963-9998","dob":"1964-04-25","age":"","mstatus":"","insh":"20032110*01","cliId":"","pno":"434\/589-8037","cno":"","email":"","ename":"","eno":"","pphy":"LANFORD, RANDOLPH E MD","ppno":"434\/842-3244","pcpadd":"4064 JAMES MADISON HIGHWAY","pcpcity":"FORK UNION","pcpstate":"VA","pcpzip":23055,"pcpcounty":"","pcpid":"","pcpname":"FORK UNION MEDICAL ASSOCIATES INC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/842-1110","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I47.1","I42.9","R00.2","N18.3","N25.1","E83.52","E21.0","Z01.419","Z85.42","E66.01","Z68.41","F20.9","R00.0","R73.09","M13.0","L71.9","E55.9","C54.1","H04.123","H25.13","H40.053","H52.4","H40.059","H52.13","L72.3","I10.","J06.9","T56.891A","N14.1"],"date":["2020-11-04","2020-11-04","2020-11-04","2020-09-28","2020-08-05","2020-01-22","2020-08-05","2020-08-17","2020-08-17","2020-08-17","2020-08-17","2020-09-28","2020-09-28","2020-09-28","2020-09-28","2020-06-30","2020-06-30","2020-08-17","2020-08-19","2020-08-19","2020-08-19","2020-08-19","2019-12-17","2019-04-18","2019-04-25","2019-11-06","2019-12-02","2019-07-03","2019-07-03"],"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":[["","43547034106","RISPERIDONE","TAB 1MG","30","Select","Select",""],["","00054002025","LITHIUM","TAB 450MG ER","30","Select","Select",""],["","16729013716","CLONAZEPAM","TAB 1MG","30","Select","Select",""],["","68682099798","DILTIAZEM","CAP 240MG ER","30","Select","Select",""],["","","TRAVOPROST","DRO 0.00004","","Select","Select",""],["","","LUBRICNT","DRO 0.4-0.3%","","Select","Select",""],["","","FLUCLVX","INJ 2020-21","","Select","Select",""],["","00065026025","TRAVATAN","DRO 0.00004","2","Select","Select",""],["","69238152201","TETRACYCLINE","CAP 250MG","60","Select","Select",""],["","49281063115","FLUZONE","INJ 2019-20","0","Select","Select",""],["","65862001905","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","68180030360","CEFUROXIME","TAB 500MG","10","Select","Select",""],["","64980030760","DENTAGEL","GEL 0.011","56","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":""}]}]}