{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KEITH   L ROBINSON","gend":0,"add":"828 PAXTON AVE APT 2","city":"DANVILLE","state":"VA","zip":"24541-9998","dob":"1977-08-11","age":"","mstatus":"","insh":"20034178*01","cliId":"","pno":"434\/792-3239","cno":"434\/228-9122","email":"","ename":"","eno":"","pphy":"VASIREDDY, SABITHA MD","ppno":"434\/791-7366","pcpadd":"142 S MAIN STREET","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"DANVILLE PHYSICIAN PRACTICES LLC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/791-3438","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","N18.6","Z99.2","A41.9","U07.1","J12.89","B97.29","J96.01","I16.1","Z20.822","I48.0","J96.21","J81.0","I12.0","G47.33","M10.9","D63.1","R73.9","E83.51","E34.3","Z95.828","Z79.1","Z79.899","Z86.16","J18.9","I50.9","J80.","I13.2","I95.89","J96.02","NO DATA","R65.21","E87.2","E87.6","I95.9","Z86.69","J96.90","R40.4","R56.9","G40.901","R53.1","R06.00","R06.9","R06.02","R09.02","R00.0","N25.81"],"date":["2021-08-11","2021-12-31","2021-12-31","2021-08-08","2021-01-23","2021-01-22","2021-01-22","2021-08-11","2021-08-11","2021-08-08","2021-01-24","2021-08-08","2021-08-08","2021-09-09","2021-08-08","2021-08-08","2021-08-08","2021-08-08","2021-08-08","2021-08-08","2021-08-08","2021-08-08","2021-09-09","2021-08-08","2021-01-23","2021-08-11","2021-01-17","2021-01-23","2021-01-18","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-09-09","2021-01-23","2021-02-10","2021-02-10","2021-02-10","2021-02-10","2021-01-14","2021-08-08","2021-01-14","2021-08-08","2021-01-14","2019-11-01"],"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":[["","68180015001","FAMOTIDINE","SUS 40MG\/5ML","50","Select","Select",""],["","59528061601","RENAPLEX-D","TAB ","90","Select","Select",""],["","68585000801","ZINC","CAP 220MG","30","Select","Select",""],["","31722053812","LEVETIRACETA","TAB 750MG","60","Select","Select",""],["","20555000100","VITAMIN","TAB 250MG","30","Select","Select",""],["","","LOSARTAN","TAB 50MG","","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","00085113204","PROVENTIL","AER HFA","7","Select","Select",""],["","31722052001","HYDRALAZINE","TAB 25MG","60","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","","CLONIDINE","TAB 0.1MG","","Select","Select",""],["","00781208102","CALC","CAP 667MG","270","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","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":""}]}]}