{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GEORGIA   M RUSH","gend":1,"add":"6910 WILLIAMSON ROAD NORTH ROANOKE ASSISTED LIVING","city":"ROANOKE","state":"VA","zip":"24019-9998","dob":"1969-07-19","age":"","mstatus":"","insh":"20034391*01","cliId":"","pno":"540\/265-2173","cno":"","email":"","ename":"","eno":"","pphy":"BROWN, BARRY DO","ppno":"540\/862-6710","pcpadd":"SUITE 100 200 ARH LANE","pcpcity":"LOW MOOR","pcpstate":"VA","pcpzip":24457,"pcpcounty":"","pcpid":"","pcpname":"WVVA HEALTH CARE ALLIANCE PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/862-7922","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.0","F29.","F70.","F25.1","R32.","Z60.9","F20.9","L60.0","E11.41","B35.1","L11.0","L57.0","M79.674","M79.675","L84.","H35.413","H25.13","E11.9","I77.89","R09.89","NO DATA","I10.","F17.200","Z68.36","H25.813","H35.9"],"date":["2021-12-31","2021-12-14","2021-12-14","2021-12-14","2021-11-05","2021-12-14","2021-07-07","2021-10-04","2021-10-04","2021-10-04","2021-10-04","2021-10-04","2021-10-04","2021-10-04","2021-10-04","2021-08-18","2021-02-17","2021-11-24","2021-12-03","2021-12-03","2020-12-23","2021-11-24","2021-11-24","2021-01-08","2021-02-03","2021-08-18"],"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":[["","","AUTOSHIELD","MIS 30GX5MM","","Select","Select",""],["","","VITAMIN","TAB 1000UNIT","","Select","Select",""],["","","PRAVASTATIN","TAB 40MG","","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","","BYETTA","INJ 10MCG","","Select","Select",""],["","","MEDROXYPR","INJ 150MG\/ML","","Select","Select",""],["","","OXYBUTYNIN","TAB 10MG ER","","Select","Select",""],["","","LISINOP\/HCTZ","TAB 20-25MG","","Select","Select",""],["","","METFORMIN","TAB 500MG","","Select","Select",""],["","","ARIPIPRAZOLE","TAB 20MG","","Select","Select",""],["","","BENZTROPINE","TAB 0.5MG","","Select","Select",""],["","08496280801","EASY","MIS LANC\/28G","8","Select","Select",""],["","","SYMBICORT","AER 80-4.5","","Select","Select",""],["","","PAIN","TAB 500MG","","Select","Select",""],["","","CLONAZEPAM","TAB 0.5MG","","Select","Select",""],["","","DIVALPROEX","TAB 500MG DR","","Select","Select",""],["","","ONETOUCH","TES VERIO","","Select","Select",""],["","","PEN  NEEDLES","MIS 31GX5MM","","Select","Select",""],["","58160088752","FLUARIX","INJ 2021-22","0","Select","Select",""],["","","BUDES\/FORMOT","AER 80-4.5","","Select","Select",""],["","","ROSUVASTATIN","TAB 5MG","","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","","TRUPLUS","MIS 28G","","Select","Select",""],["","","ALCOHOL","PAD 0.7","","Select","Select",""],["","","NITROGLYCERN","SUB 0.4MG","","Select","Select",""],["","","BREO","INH 100-25","","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}