{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WANDA PILLOW","gend":1,"add":"2135 MURRELL RD LOT 321","city":"LYNCHBURG","state":"VA","zip":24501,"dob":"1958-01-17","age":"","mstatus":"","insh":"20033441*01","cliId":"","pno":"434\/420-5414","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"434\/455-5330","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":24501,"pcpcounty":"","pcpid":"","pcpname":"JOHNSON HEALTH CENTER","plan":"OHP","program":"Medicaid","lob":"OHCC","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/455-3273","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H25.043","E11.9","H52.4","H53.9","E11.49","L60.0","L84.","M79.674","M79.675","H18.51","H25.12","E11.65","E55.9","I10.","E78.5","K21.9","H25.012","F41.9","H25.11","B35.1","R21.","L21.9","Z23.","E78.00","F39.","L03.031"],"date":["2019-07-24","2019-07-24","2019-07-24","2019-07-24","2022-10-12","2022-10-12","2021-07-09","2022-10-12","2022-10-12","2019-09-16","2019-11-06","2022-02-15","2021-04-16","2022-02-15","2022-02-15","2021-07-23","2019-11-06","2021-03-10","2019-10-23","2022-10-12","2020-10-09","2020-10-09","2020-10-09","2020-01-15","2022-02-15","2022-10-12"],"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":[["","","JANUVIA"," JANUVIA ","30","Select","Select",""],["","","PIOGLITAZONE"," PIOGLITAZONE ","30","Select","Select",""],["","","POT  CHLORIDE"," POT  CHLORIDE","60","Select","Select",""],["","","SERTRALINE"," SERTRALINE ","45","Select","Select",""],["","","VALSART\/HCTZ"," VALSART\/HCTZ ","30","Select","Select",""],["","","SOLIFENACIN"," SOLIFENACIN ","90","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","30","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","30","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","","PANTOPRAZOLE"," PANTOPRAZOLE ","30","Select","Select",""],["","","CLONAZEPAM"," CLONAZEPAM ","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","26","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","49281042250","FLUZONE","INJ 2022-23","0","Select","Select",""],["","53191036201","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","00245531615","KLOR-CON","TAB 10MEQ ER","60","Select","Select",""],["","65702071110","ACCU-CHEK","TES GUIDE","50","Select","Select",""],["","00093834410","GLYBURIDE","TAB 5MG","60","Select","Select",""],["","","TRIAMCINOLON","LOT 0.001","","Select","Select",""],["","50924097110","SOFTCLIX","MIS LANCETS","100","Select","Select",""],["","","SHINGRIX","INJ 50\/0.5ML","","Select","Select",""],["","","ALLERGY","TAB 10MG","","Select","Select",""],["","","AFLURIA","INJ 2020-21","","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":""}]}]}