{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JUAN NIEVES-VELEZ","gend":0,"add":"1241 N MAIN ST TONY CRUZ","city":"HARRISONBURG","state":"VA","zip":22802,"dob":"1980-06-24","age":"","mstatus":"","insh":"20038819*01","cliId":"","pno":"540\/560-5899","cno":"","email":"","ename":"","eno":"","pphy":"Johnston, Paul","ppno":"540\/564-7300","pcpadd":"1661 South Main Street ","pcpcity":"Harrisonburg","pcpstate":"VA","pcpzip":22802,"pcpcounty":"","pcpid":"","pcpname":"SRMHMG - Sentara South Main Health Center","plan":"OHP","program":"Medicaid","lob":"OHCC","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/431-7100","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.0","F22.","Z20.822","E11.65","E78.2","K21.9","D56.3","F10.10","F10.99","NO DATA","I10.","G47.33","F41.9","F17.210","Z90.49","Z79.84","Z79.899","Z59.00","Z82.49","Z80.42","R52.","M54.89","Z71.3","E78.5","F20.9","M54.5","G89.29","M72.2","R07.81","F51.5","G47.10","Z78.9","N47.1","Z01.818","Z41.2"],"date":["2021-12-27","2021-12-23","2021-12-23","2021-09-07","2021-09-07","2021-09-07","2021-10-13","2021-12-27","2021-12-23","2021-12-23","2021-12-23","2021-12-23","2021-12-23","2021-12-23","2021-12-23","2021-12-23","2021-12-23","2021-12-23","2021-12-23","2021-12-23","2019-11-22","2019-11-22","2019-02-26","2019-02-26","2019-02-26","2019-11-22","2019-11-22","2019-07-09","2019-11-11","2019-04-08","2019-04-08","2019-04-08","2019-02-19","2019-02-07","2019-02-07"],"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":[["","","OLANZAPINE"," OLANZAPINE ","56","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","30","Select","Select",""],["","","DIVALPROEX"," DIVALPROEX ","112","Select","Select",""],["","","LISINOPRIL"," LISINOPRIL ","28","Select","Select",""],["","","PRAZOSIN","CAP 1MG","","Select","Select",""],["","","ONETOUCH"," ONETOUCH ","200","Select","Select",""],["","","BUSPIRONE"," BUSPIRONE ","124","Select","Select",""],["","","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","","METFORMIN"," METFORMIN ","60","Select","Select",""],["","","HALOPERIDOL"," HALOPERIDOL ","30","Select","Select",""],["","66004085004","KROGER","TES ","1","Select","Select",""],["","","NYSTAT\/TRIAM"," NYSTAT\/TRIAM ","15","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","30","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","12","Select","Select",""],["","","AMOXICILLIN"," AMOXICILLIN ","20","Select","Select",""],["","","METHYLPRED"," METHYLPRED ","21","Select","Select",""],["","","OXYCODONE"," OXYCODONE ","12","Select","Select",""],["","","ZOLPIDEM","TAB 5MG","","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":""}]}]}