{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIMBERLY   A JOHNSON","gend":1,"add":"606 W CORK ST APT 7","city":"WINCHESTER","state":"VA","zip":"22601-9998","dob":"1966-07-31","age":"","mstatus":"","insh":"20044040*01","cliId":"","pno":"571\/235-8102","cno":"619\/932-2212","email":"","ename":"","eno":"","pphy":"LAMAS RODRIGUEZ, CANDY MD","ppno":"540\/722-2369","pcpadd":"1330 AMHERST STREET","pcpcity":"WINCHESTER","pcpstate":"VA","pcpzip":"22601","pcpcounty":"","pcpid":"","pcpname":"SHENANDOAH VALLEY MEDICAL SYSTEM INC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/722-6601","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.1","B35.1","M79.675","F25.0","F43.10","I10.","R07.9","R63.5","Z71.3","NO DATA","H43.393","Z71.82","Z68.39","D25.9","G47.33","D25.1","D25.2","E66.01","R73.03","D75.1","Z76.89","R10.0","R60.9","R40.0","E55.9","Z23.","R29.818","M25.562","L71.9","R10.32","D22.39","L82.1","D22.9","H04.123","R74.8","E66.9","L65.9","Z01.419","Z12.4","Z11.51","Z12.31","N93.8","Z68.36","D21.9","R10.13","R19.7","R21.","Z68.38","Z68.41"],"date":["2021-01-12","2021-01-07","2020-09-11","2021-12-30","2021-04-09","2021-10-26","2021-03-08","2021-03-08","2021-12-14","2020-10-28","2020-10-28","2021-12-29","2021-12-14","2021-10-26","2021-10-26","2021-10-26","2021-10-26","2021-12-29","2021-12-29","2021-11-24","2021-12-29","2021-05-24","2021-09-14","2021-09-01","2021-09-01","2021-09-01","2021-12-14","2021-12-14","2021-07-13","2021-06-07","2020-03-06","2020-03-06","2020-03-06","2020-12-10","2021-05-28","2021-09-14","2021-09-14","2020-10-22","2020-10-22","2020-10-22","2020-10-22","2020-10-22","2020-10-22","2021-05-24","2021-05-24","2021-05-24","2021-07-02","2021-07-02","2021-11-05"],"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":[["","47781017801","AMPHET\/DEXTR","TAB 15MG","30","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","8","Select","Select",""],["","29300012910","HYDROCHLOROT","TAB 50MG","90","Select","Select",""],["","60505015701","BUPROPION","TAB 100MG","60","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","8","Select","Select",""],["","51672421503","METRONIDAZOL","GEL 0.01","60","Select","Select",""],["","61874011530","VRAYLAR","CAP 1.5MG","30","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX5\/32","100","Select","Select",""],["","00904699960","DOCUSATE","CAP 250MG","14","Select","Select",""],["","00169406012","VICTOZA","INJ 18MG\/3ML","3","Select","Select",""],["","68462010630","ONDANSETRON","TAB 8MG","12","Select","Select",""],["","00169280015","SAXENDA","INJ 18MG\/3ML","15","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","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":""}]}]}