{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WILLIAM   D STUMP III","gend":0,"add":"PO BOX 458","city":"NEWBERN","state":"VA","zip":"24126-9998","dob":"1989-01-01","age":"","mstatus":"","insh":"20035779*01","cliId":"","pno":"540\/674-4106","cno":"","email":"","ename":"","eno":"","pphy":"ABUANNADI, MOHAMMAD MD","ppno":"434\/243-1000","pcpadd":"1221 LEE ST","pcpcity":"CHARLOTTESVILLE","pcpstate":"VA","pcpzip":22908,"pcpcounty":"","pcpid":"","pcpname":"UNIVERSITY OF VIRGINIA PHYSICIANS GROUP","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/982-1998","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L53.8","T82.7XXA","Z95.811","Z45.2","I50.22","I42.8","Z79.2","Z51.81","Z79.01","E43.","L02.211","F12.20","T81.31XA","NO DATA","Z68.1","F17.210","Z86.711","Z86.718","Z79.899","Z79.82","Z79.891","T82.9XXD","I10.","G89.29","F12.90","Z72.0","V54.19","W19.XXXD","T82.9XXA","I35.1","I34.0","Q23.1","Z23.","S42.031A","W19.XXXA","I45.10","I45.9","R07.89","I50.9","S21.109A","Z51.5","Z86.59","R52.","V58.89","K59.00","R00.1","B96.89","Z90.49","S42.001A","T84.9XXA","I51.7","Z86.19","R93.1","I26.99","R93.89","T82.7XXD","F12.10","H31.092","Z46.82","R18.8","R94.31","I42.9","Z87.891","F54.","I25.5","F11.20","Z20.822","R79.1","Z86.73","M79.89","I36.1","K65.1","L02.213","Z86.79","Z45.09","I25.2","Z11.59","R06.02","Z82.49","I49.9"],"date":["2020-06-30","2022-07-06","2022-09-28","2022-03-01","2022-07-06","2022-07-06","2022-03-01","2022-03-07","2022-07-06","2021-07-12","2022-01-14","2022-04-11","2021-06-30","2022-02-14","2021-06-30","2021-07-12","2022-03-15","2021-06-30","2022-03-15","2022-03-15","2021-06-30","2021-07-11","2022-02-09","2021-07-14","2022-03-15","2021-07-14","2021-10-25","2021-10-25","2020-07-28","2020-07-29","2020-07-29","2020-09-28","2020-09-28","2020-11-11","2020-11-11","2021-06-30","2021-06-30","2021-07-09","2022-09-26","2021-06-30","2021-07-06","2021-07-05","2021-07-10","2022-01-23","2020-07-01","2020-07-01","2020-07-01","2020-07-28","2020-10-22","2021-06-30","2021-07-02","2021-07-05","2021-07-05","2020-01-08","2020-07-31","2021-07-07","2022-02-14","2021-01-21","2021-07-05","2022-01-18","2022-02-14","2022-03-15","2022-03-23","2022-04-11","2022-03-01","2022-01-14","2022-03-11","2022-01-14","2022-01-14","2022-01-14","2022-01-15","2022-02-22","2022-01-21","2022-03-23","2022-02-14","2022-02-14","2022-02-14","2022-03-15","2022-03-15","2022-09-26"],"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":[["","68382066005","SPIRONOLACT","TAB 25MG","90","Select","Select",""],["","00093172110","WARFARIN","TAB 5MG","40","Select","Select",""],["","59762134601","PREGABALIN","CAP 75MG","90","Select","Select",""],["","43547035411","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","55111046805","METOPROL","TAB 100MG ER","30","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","51672131200","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","","ASPIRIN","TAB 325MG","","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","59676058015","JANSSEN","INJ COVID-19","0","Select","Select",""],["","00832121600","JANTOVEN","TAB 5MG","60","Select","Select",""],["","63868091410","QC","TAB 325MG EC","30","Select","Select",""],["","00955100810","ENOXAPARIN","INJ 80\/0.8ML","17","Select","Select",""],["","","POVIDONE\/IOD","SOL 0.1","","Select","Select",""],["","","HIBICLENS","LIQ 0.04","","Select","Select",""],["","13107004605","OXYCOD\/APAP","TAB 10-325MG","90","Select","Select",""],["","27241009990","DULOXETINE","CAP 60MG","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":""}]}]}