{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AUSTIN   T SPROUSE","gend":0,"add":"9345 OLD COUNTY ROAD","city":"GROTTOES","state":"VA","zip":"24441-9998","dob":"1999-04-04","age":"","mstatus":"","insh":"20035472*01","cliId":"","pno":"540\/470-8231","cno":"","email":"","ename":"","eno":"","pphy":"DEARING, DEONNA L NP","ppno":"540\/298-1200","pcpadd":"13737 SPOTSWOOD TRAIL","pcpcity":"ELKTON","pcpstate":"VA","pcpzip":22827,"pcpcounty":"","pcpid":"","pcpname":"SRMHMG - Sentara East Rockingham Health Center","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/579-8587","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L25.9","L21.0","Z23.","F84.0","J45.909","M79.672","E66.9","Z00.01","E66.01","Z13.89","L21.8","B36.8","L01.01","Z00.00","L20.9","M10.9","L30.1","Z76.89","J45.20","Z91.09","M10.079","R44.2","I73.00","Z68.38","M10.071"],"date":["2021-01-12","2021-01-12","2020-10-13","2022-10-05","2022-05-06","2021-01-05","2021-01-05","2020-11-12","2022-10-05","2020-11-12","2022-03-24","2022-03-24","2022-03-24","2022-05-06","2022-05-06","2022-05-06","2022-10-05","2022-10-05","2022-10-05","2022-10-05","2022-10-05","2022-10-05","2022-10-05","2022-10-05","2022-04-20"],"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":[["","51672129803","KETOCONAZOLE","CRE 0.02","60","Select","Select",""],["","","MONTELUKAST"," MONTELUKAST ","30","Select","Select",""],["","16714003902","COLCHICINE","TAB 0.6MG","21","Select","Select",""],["","31722054301","INDOMETHACIN","CAP 50MG","15","Select","Select",""],["","00378827052","ALBUTEROL","NEB 0.00083","75","Select","Select",""],["","16714004107","ALLOPURINOL","TAB 100MG","60","Select","Select",""],["","45802006535","TRIAMCINOLON","CRE 0.005","15","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","14","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","","ALLERGY","SYP 5MG\/5ML","","Select","Select",""],["","49348033334","LORATADINE","SYP 5MG\/5ML","300","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":""}]}]}