{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOYCE   W SHIPP","gend":1,"add":"810 MALLSIDE FOREST CT APT 103","city":"CHARLOTTESVILLE","state":"VA","zip":"22901-9998","dob":"1947-10-01","age":"","mstatus":"","insh":"20034896*01","cliId":"","pno":"","cno":"","email":"","ename":"","eno":"","pphy":"SCHECTMAN, JOEL M MD","ppno":"434\/924-1931","pcpadd":"1222 JEFFERSON PARK AVE","pcpcity":"CHARLOTTESVILLE","pcpstate":"VA","pcpzip":22903,"pcpcounty":"","pcpid":"","pcpname":"UNIVERSITY OF VIRGINIA PHYSICIANS GROUP","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/243-5906","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L30.9","R21.","H25.043","H44.23","I65.23","I70.0","Z87.891","L98.491","B36.9","I10.","Z71.6","R06.02","Z72.0","Z71.89","F17.200","L30.8","Z20.828"],"date":["2021-08-16","2021-08-16","2019-12-17","2019-12-17","2019-02-14","2019-02-14","2019-02-14","2019-07-25","2019-08-23","2021-08-16","2021-08-16","2021-01-11","2021-01-11","2021-08-16","2019-02-21","2020-01-22","2021-01-07"],"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":[["","","LISINOPRIL"," LISINOPRIL ","90","Select","Select",""],["","","ADVAIR"," ADVAIR ","60","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","30","Select","Select",""],["","","WIXELA"," WIXELA ","60","Select","Select",""],["","","TRIAMCINOLON"," TRIAMCINOLON ","60","Select","Select",""],["","","BUPROPN"," BUPROPN ","30","Select","Select",""],["","","CLOBETASOL"," CLOBETASOL ","60","Select","Select",""],["","","TACROLIMUS"," TACROLIMUS ","60","Select","Select",""],["","","UREA"," UREA ","80","Select","Select",""],["","","ELIDEL"," ELIDEL ","100","Select","Select",""],["","","HYDROCHLOROT"," HYDROCHLOROT ","30","Select","Select",""],["","","TERBINAFINE"," TERBINAFINE ","30","Select","Select",""],["","","DUODERM"," DUODERM ","20","Select","Select",""],["","","CVS"," CVS ","100","Select","Select",""],["","","MUPIROCIN"," MUPIROCIN ","22","Select","Select",""],["","","PIMECROLIMUS"," PIMECROLIMUS ","100","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":""}]}]}