{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JUSTIN   D SCOTT","gend":0,"add":"1409 ANDERSON ST","city":"GLASGOW","state":"VA","zip":"24555-9998","dob":"1964-11-02","age":"","mstatus":"","insh":"20034646*01","cliId":"","pno":"434\/329-9310","cno":"","email":"","ename":"","eno":"","pphy":"SAYRE, WILLIAM MD","ppno":"540\/463-9141","pcpadd":"1 HEALTH CIRCLE","pcpcity":"LEXINGTON","pcpstate":"VA","pcpzip":24450,"pcpcounty":"","pcpid":"","pcpname":"Nursing Home Kendal at Lexington","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R19.7","Z01.810","L60.0","M79.675","L98.9","H35.372","G43.C0","H52.4","Z96.1","K40.00","L03.032","B00.0","B07.0","F41.9","J20.9","R30.9","R20.0","I65.22","K40.90","R51.","Z23.","R20.2","H43.812","H52.223","S39.011A","X58.XXXA","R42.","R10.30","R53.83","E55.9","G56.03","D23.4","R05."],"date":["2019-02-10","2019-03-06","2019-05-13","2019-05-13","2021-03-29","2021-04-26","2021-04-26","2021-04-26","2021-04-26","2019-03-19","2019-04-15","2019-04-15","2019-04-15","2020-01-06","2019-01-09","2019-01-09","2020-07-17","2020-07-20","2019-03-19","2020-03-04","2020-01-06","2019-10-18","2019-01-30","2019-01-30","2021-07-01","2021-07-01","2019-01-25","2019-01-25","2019-01-25","2019-01-25","2019-11-26","2021-04-12","2021-08-17"],"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":[["","","SERTRALINE"," SERTRALINE ","30","Select","Select",""],["","","OMEPRAZOLE"," OMEPRAZOLE ","60","Select","Select",""],["","","ARIPIPRAZOLE"," ARIPIPRAZOLE ","30","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","45","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","61442010310","DICLOFENAC","TAB 75MG DR","60","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":""}]}]}