{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DANNY   M THOMPSON","gend":0,"add":"262 ROBERTSON RD APT B21","city":"CRAIGSVILLE","state":"VA","zip":"24430-9998","dob":"1959-05-25","age":"","mstatus":"","insh":"20036190*01","cliId":"","pno":"540\/292-2560","cno":"","email":"","ename":"","eno":"","pphy":"CAMPBELL, JOHN S MD","ppno":"540\/885-6789","pcpadd":"SUITE 111 42 LAMBERT ST","pcpcity":"STAUNTON","pcpstate":"VA","pcpzip":24401,"pcpcounty":"","pcpid":"","pcpname":"EMERGICARE INC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/886-7364","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.42","I95.9","R04.0","I25.10","F33.2","I10.","K21.9","E87.5","Z68.34","Z23.","F33.41","F33.1","R13.10","R19.5","Z79.02","Z20.822","R06.02","B34.9","R19.7","R10.84","E11.65","E78.2","Z95.5","E11.9","E55.9","F32.9","E11.8","Z79.4","E78.5","R12.","M25.571","M79.604","R05.9","R69.","M79.671","E11.40","B97.4","R09.81","R09.89","R43.8","Z95.9","Z98.890","Z79.899","Z68.31","J30.9","M77.41","B02.9","L03.319","T82.855A","I25.110","E11.649","E78.1","Z87.440","Z79.82","G47.00","F41.9","Z82.49","Z83.3","I20.0","B35.1","L60.0","M79.674","M79.675","F41.8","R10.9","R52.","H25.13","H40.013","R07.89","K92.1","D18.01","L57.8","Z09.","Z87.2","D48.5","R07.9","R79.9","B35.3","D22.5","L82.1","S60.521A","L82.0","L29.8","L53.8","L85.3","L81.4","L57.0","I25.119","Z20.828","Z98.61","L73.8","Z11.59","M19.071","R53.1","R05.","Z03.818","J12.1","R39.9","M54.6","R50.9","R82.90","R39.89","M54.5","D22.4","I25.84","E56.9","L98.9","J30.2","Z68.30","R61.","E11.69","H35.351","J20.9","J06.9","K22.2","R10.12","R13.19","R68.81","E78.00"],"date":["2021-12-21","2021-04-22","2020-07-01","2021-11-02","2021-02-01","2021-12-14","2021-12-14","2020-10-29","2020-10-29","2021-12-14","2021-09-09","2021-01-12","2020-12-02","2020-12-02","2020-12-02","2021-11-02","2021-11-02","2021-02-04","2021-12-14","2021-09-10","2021-10-21","2021-05-05","2021-03-22","2021-11-02","2021-05-05","2021-11-02","2021-12-02","2021-12-02","2021-03-22","2020-09-02","2020-10-20","2020-10-20","2021-11-02","2021-11-02","2020-11-05","2021-05-26","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-12-14","2021-12-14","2020-10-26","2021-01-29","2021-01-29","2020-06-21","2020-06-21","2020-06-21","2020-06-21","2020-06-21","2020-06-21","2020-06-21","2020-06-21","2020-06-21","2020-06-21","2020-06-23","2021-01-05","2021-01-05","2021-01-05","2021-01-05","2021-05-03","2021-09-10","2021-09-10","2021-05-20","2021-05-20","2020-06-21","2021-07-26","2020-02-19","2020-11-17","2020-11-17","2020-10-01","2020-02-19","2020-06-21","2020-10-20","2020-11-17","2020-11-17","2020-11-17","2020-11-17","2020-11-17","2020-11-17","2020-11-17","2020-11-17","2020-11-17","2020-11-17","2020-05-15","2020-06-15","2020-06-22","2020-10-01","2020-10-01","2020-11-05","2021-02-04","2021-02-04","2021-11-02","2021-11-02","2020-02-29","2020-02-29","2020-06-15","2020-06-15","2019-05-28","2019-05-28","2019-09-11","2019-05-16","2019-05-16","2019-05-16","2019-02-11","2019-02-11","2019-03-11","2019-03-11","2019-05-14","2019-06-10","2019-07-25","2019-04-09","2019-10-14","2019-02-26","2019-06-24","2019-05-16"],"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":[["","","CITALOPRAM"," CITALOPRAM ","56","Select","Select",""],["","","TRAZODONE"," TRAZODONE ","28","Select","Select",""],["","","METOPROL"," METOPROL ","56","Select","Select",""],["","","CLOPIDOGREL"," CLOPIDOGREL ","28","Select","Select",""],["","","JARDIANCE"," JARDIANCE ","28","Select","Select",""],["","","LANTUS"," LANTUS ","15","Select","Select",""],["","","LISINOPRIL"," LISINOPRIL ","28","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","28","Select","Select",""],["","","PANTOPRAZOLE"," PANTOPRAZOLE ","28","Select","Select",""],["","","BD  PEN NEEDL"," BD  PEN NEEDL","100","Select","Select",""],["","","JANUMET"," JANUMET ","56","Select","Select",""],["","","MELATONIN"," MELATONIN ","28","Select","Select",""],["","","ARIPIPRAZOLE"," ARIPIPRAZOLE ","28","Select","Select",""],["","","ONETOUCH"," ONETOUCH ","400","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","TES LITE","100","Select","Select",""],["","","MONTELUKAST"," MONTELUKAST ","28","Select","Select",""],["","45802046611","ECONAZOLE","CRE 0.01","60","Select","Select",""],["","23155022901","ACYCLOVIR","CAP 200MG","140","Select","Select",""],["","","NOVOLOG"," NOVOLOG ","30","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","","BENZONATATE"," BENZONATATE ","30","Select","Select",""],["","65702040810","ACCU-CHEK","TES AVIVA PL","100","Select","Select",""],["","00002143380","TRULICITY","INJ 0.75\/0.5","2","Select","Select",""],["","62756014201","METFORMIN","TAB 500MG ER","112","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","NITROGLYCERN","SUB 0.4MG","","Select","Select",""],["","","LORATADINE"," LORATADINE ","28","Select","Select",""],["","","FLUZONE"," FLUZONE ","0","Select","Select",""],["","","FLUARIX"," FLUARIX ","0","Select","Select",""],["","","RANITIDINE"," RANITIDINE ","28","Select","Select",""],["","","DOXYCYCL"," DOXYCYCL ","14","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","6","Select","Select",""],["","","LANCET"," LANCET ","400","Select","Select",""],["","","OMEPRAZOLE"," OMEPRAZOLE ","60","Select","Select",""],["","","FREESTYLE    MIS READER"," FREESTYLE    MIS READER","2","Select","Select",""],["","","FREESTYLE    KIT SENSOR","KIT SENSOR","","Select","Select",""],["","","SMZ\/TMP","TAB 800-160","","Select","Select",""],["","","ISOSORB","TAB 30MG ER","","Select","Select",""],["","","GAVILYTE-G","SOL ","","Select","Select",""],["","","FLUBLOK","INJ 2020-21","","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":""}]}]}