{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LOUIS PIPARO","gend":0,"add":"101 EARLY MEADOWS CT","city":"SANDSTON","state":"VA","zip":"23150-9998","dob":"1959-01-29","age":"","mstatus":"","insh":"20033447*01","cliId":"","pno":"804\/901-1642","cno":"","email":"","ename":"","eno":"","pphy":"VOTA, SCOTT DO","ppno":"804\/325-8720","pcpadd":"8266 ATLEE RD SUITE 330","pcpcity":"MECHANICSVILLE","pcpstate":"VA","pcpzip":23116,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS RICHMOND COMMUNITY HOSPITAL LLC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/764-7351","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G40.909","H20.012","S39.012A","Z13.220","N40.0","J44.9","Z72.0","K21.9","R06.00","T15.02XA","H54.7","Z68.24","V58.89","K21.0","N13.9","E55.9","Z87.891","I10.","R79.9","Z92.29","R53.1","R06.02","H10.32","F17.210","H57.12","H10.9","K52.9","K26.9"],"date":["2021-06-18","2020-11-16","2021-05-18","2021-06-18","2021-06-18","2021-06-18","2021-06-18","2021-06-18","2021-06-18","2020-11-16","2020-11-16","2019-10-29","2019-01-22","2019-06-19","2019-06-19","2019-06-19","2019-06-19","2019-06-19","2019-06-19","2019-06-19","2019-06-19","2019-06-19","2019-06-23","2019-06-23","2019-06-23","2019-06-27","2019-07-22","2019-07-22"],"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":[["","","DULERA"," DULERA ","13","Select","Select",""],["","","OMEPRAZOLE"," OMEPRAZOLE ","30","Select","Select",""],["","","DIVALPROEX"," DIVALPROEX ","180","Select","Select",""],["","","CARBAMAZEPIN"," CARBAMAZEPIN ","180","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","8","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","","CYCLOBENZAPR"," CYCLOBENZAPR ","15","Select","Select",""],["","","HYDROXYZ"," HYDROXYZ ","30","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","TAMSULOSIN"," TAMSULOSIN ","30","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","","NAPROXEN"," NAPROXEN ","60","Select","Select",""],["","","FINASTERIDE"," FINASTERIDE ","30","Select","Select",""],["","","LATANOPROST"," LATANOPROST ","2","Select","Select",""],["","","MELOXICAM"," MELOXICAM ","30","Select","Select",""],["","","BENZONATATE"," BENZONATATE ","30","Select","Select",""],["","","DOXYCYC"," DOXYCYC ","20","Select","Select",""],["","","POLYMYXIN"," POLYMYXIN ","10","Select","Select",""],["","","CIPROFLOXACN"," CIPROFLOXACN ","14","Select","Select",""],["","","METRONIDAZOL"," METRONIDAZOL ","14","Select","Select",""],["","","TRAMADOL"," TRAMADOL ","15","Select","Select",""],["","","KETOROLAC","TAB 10MG","","Select","Select",""],["","","TOBRAMYCIN","SOL 0.3% OP","","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","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":""}]}]}