{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PATRICIA  A YANCEY","gend":1,"add":"709 RIVER RIDGE ROAD PINCREST ADULT HOME","city":"DANVILLE","state":"VA","zip":24541,"dob":"1956-01-22","age":"","mstatus":"","insh":"20037991*01","cliId":"","pno":"434\/799-9482","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"434\/835-4876","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"GO DOCS","plan":"OHP","program":"Medicaid","lob":"OHCC","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/835-4875","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.1","L30.8","C18.9","J30.2","G44.89","F20.9","G20.","NO DATA","E11.9","Z79.84","K50.90","Z12.11","F20.0","R00.1","I45.9","Z20.822","E78.1","R51.9","L30.9","I87.2","R40.0","G44.52","Z90.49","K57.90","Z80.0","K59.00","F03.91","L20.9","Z85.038","Z23.","L29.9","L85.3","R23.8","E78.5","R10.9","G44.221","R42.","H61.22","K50.80","E66.9","Z11.1","H93.90","H61.23","F25.0","H43.89","H25.13","R10.13","R51.","Z13.6","I49.3","R00.0","Z79.899","H43.811","H10.413","R79.89","I49.1","Z86.79","N18.9","R94.5","K59.09","R07.2","K44.9","I49.5","K21.9","K62.89","F17.210","D50.9"],"date":["2022-11-21","2021-03-18","2022-09-08","2022-10-20","2022-10-20","2022-10-20","2022-10-20","2022-10-20","2022-10-20","2022-02-17","2022-10-25","2022-10-25","2022-10-06","2021-11-12","2021-11-12","2021-12-17","2022-02-17","2021-04-29","2022-10-20","2022-10-20","2021-03-18","2021-09-23","2022-08-08","2022-10-25","2022-01-20","2022-10-25","2020-02-07","2020-10-01","2020-10-01","2022-10-20","2020-01-16","2020-01-16","2020-01-16","2020-01-16","2021-01-28","2021-06-10","2021-07-15","2021-07-15","2020-02-07","2020-06-11","2022-06-23","2020-05-14","2020-05-14","2019-12-28","2019-03-12","2019-03-12","2022-07-19","2019-08-01","2019-10-31","2019-10-31","2019-10-31","2019-07-10","2019-04-18","2019-04-18","2019-09-05","2019-09-24","2019-09-24","2019-10-10","2019-10-10","2019-04-12","2019-10-31","2019-06-25","2019-11-10","2022-07-19","2022-03-03","2022-10-20","2022-10-25"],"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":[["","56151146304","TRUE","TES GLUCOSE","50","Select","Select",""],["","55111025960","ZIPRASIDONE","CAP 80MG","93","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","31","Select","Select",""],["","00172572880","FAMOTIDINE","TAB 20MG","31","Select","Select",""],["","","HUMIRA","INJ 40\/0.4ML","","Select","Select",""],["","63304044330","FENOFIBRATE","CAP 43MG","30","Select","Select",""],["","00904615760","VITAMIN","TAB 2000UNIT","31","Select","Select",""],["","49884032255","OLANZAPINE","TAB 15MG ODT","62","Select","Select",""],["","51660002944","OMEPRAZOLE","TAB 20MG DR","30","Select","Select",""],["","","ACETAMINOPHE","TAB 325MG","","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","69367024324","HYDROCORT","SUP 25MG","7","Select","Select",""],["","64980032430","PROCTOZONE","CRE -HC 2.5%","30","Select","Select",""],["","23155010310","METFORMIN","TAB 850MG","31","Select","Select",""],["","00536117810","MECLIZINE","TAB 12.5MG","30","Select","Select",""],["","","FENOFIBRIC","CAP 45MG DR","","Select","Select",""],["","11534016503","FOLIC","TAB 1MG","31","Select","Select",""],["","42806055212","OMEGA-3-ACID","CAP 1GM","120","Select","Select",""],["","45802086803","POLYETH","POW 3350 NF","510","Select","Select",""],["","","ALCOHOL","PAD MED 70%","","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","","PEG3350","POW ","","Select","Select",""],["","","EAR","DRO 0.065","","Select","Select",""],["","49483034010","ACETAMIN","TAB 325MG","60","Select","Select",""],["","","ATOPICLAIR","CRE ","","Select","Select",""],["","","GOLYTELY","SOL ","","Select","Select",""],["","","BISACODYL","TAB 5MG EC","","Select","Select",""],["","60505257908","ATORVASTATIN","TAB 20MG","31","Select","Select",""],["","70069000801","EPINASTINE","DRO 0.0005","5","Select","Select",""],["","37000074084","METAMUCIL","POW 58.6%ORG","425","Select","Select",""],["","72057000101","ATOPADERM","CRE ","100","Select","Select",""],["","54092019112","PENTASA","CAP 500MG CR","186","Select","Select",""],["","","LOPERAMIDE","CAP 2MG","","Select","Select",""],["","00603243832","BENZTROPINE","TAB 1MG","60","Select","Select",""],["","","MINERIN","CRE ","","Select","Select",""],["","","HYLAGUARD","CRE ","","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","28","Select","Select",""],["","00904198280","MAPAP","TAB 325MG","60","Select","Select",""],["","00904572872","ALLERGY","TAB 10MG","30","Select","Select",""],["","00536187516","REGULOID","POW 0.586","426","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","18","Select","Select",""],["","63304069201","CLINDAMYCIN","CAP 150MG","28","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":""}]}]}