{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ALEX FITZHUGH","gend":0,"add":"68 BEAGLE GAP RUN","city":"WAYNESBORO","state":"VA","zip":"22980-9998","dob":"1982-12-27","age":"","mstatus":"","insh":"20051248*01","cliId":"","pno":"703\/304-0488","cno":"","email":"","ename":"","eno":"","pphy":"JOYCE, RICHARD A MD","ppno":"434\/286-6434","pcpadd":"295 EAST MAIN STREET","pcpcity":"SCOTTSVILLE","pcpstate":"VA","pcpzip":24590,"pcpcounty":"","pcpid":"","pcpname":"RICHARD A JOYCE MD","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/286-6436","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.5","F31.30","F11.99","F31.4","F11.94","F51.05","F99.","F11.24","Z13.220","F17.210","F15.20","F33.1","F31.63","F17.219","S62.306A","S62.336A","L30.9","F34.1","F33.2","J40.","F32.1","F11.21","L25.9","N48.89","F41.9","S62.330A","W19.XXXA","S69.91XA","F32.9","Z47.89","M75.41","L97.512","L97.522","E11.621","I73.89","F17.218","F11.20","Z68.36","F43.21","E66.09","M25.511","M75.21","V58.89","S43.431A","F31.9","G89.18","E11.9","L89.151","N52.2","Z79.4","F17.200","L97.511","L89.90","L03.90","M54.42","S29.9XXA","S89.91XA","S69.92XA"],"date":["2021-09-16","2021-02-15","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2020-07-26","2020-08-03","2021-09-16","2021-09-16","2021-10-06","2020-02-20","2021-09-16","2021-02-18","2020-01-16","2020-09-21","2020-03-12","2020-07-19","2020-07-19","2020-07-19","2020-05-28","2019-07-22","2019-06-13","2019-09-04","2019-09-04","2019-10-21","2019-10-21","2019-10-21","2019-10-21","2019-10-21","2019-10-21","2019-10-21","2019-05-31","2019-05-31","2019-05-06","2019-05-31","2019-10-16","2019-05-31","2019-09-24","2019-09-24","2019-09-24","2019-09-24","2019-11-14","2019-09-23","2019-03-14","2019-03-14","2022-04-25","2022-05-27","2022-05-27","2022-05-27"],"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":[["","00406055201","OXYCODONE","TAB 5MG","40","Select","Select",""],["","76385012450","METHOCARBAM","TAB 750MG","28","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","14","Select","Select",""],["","00093216568","NALOXONE","SPR ","2","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","","TRAZODONE","TAB 50MG","","Select","Select",""],["","","HYDROXYZ","TAB 25MG","","Select","Select",""],["","69097083512","SERTRALINE","TAB 100MG","45","Select","Select",""],["","","ARIPIPRAZOLE","TAB 5MG","","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","","HYDROMORPHON","TAB 2MG","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","","CLOBETASOL","OIN 0.0005","","Select","Select",""],["","","PREDNISONE","TAB 10MG","","Select","Select",""],["","","DOXYCYCL","TAB 100MG","","Select","Select",""],["","10370010150","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","63402030630","LATUDA","TAB 60MG","30","Select","Select",""],["","","PROMETHAZINE","TAB 25MG","","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","","QUETIAPINE","TAB 25MG","","Select","Select",""],["","","TRIAMCINOLON","CRE 0.001","","Select","Select",""],["","","MELOXICAM","TAB 15MG","","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","00071101668","LYRICA","CAP 150MG","120","Select","Select",""],["","57664050183","MIRTAZAPINE","TAB 45MG","90","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","08290320109","BD  PEN NEEDL","MIS 31GX8MM","60","Select","Select",""],["","16729008110","NALTREXONE","TAB 50MG","30","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","40","Select","Select",""],["","50111033301","METRONIDAZOL","TAB 250MG","21","Select","Select",""],["","43598029590","PREGABALIN","CAP 150MG","120","Select","Select",""],["","65862020290","LOSARTAN","TAB 50MG","30","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","28","Select","Select",""],["","00904673080","ACETAMIN","TAB 500MG","20","Select","Select",""],["","69097084615","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","00093534356","SILDENAFIL","TAB 100MG","30","Select","Select",""],["","00093321915","KETOCONAZOLE","CRE 0.02","30","Select","Select",""],["","57896098110","ASPIRIN","TAB 81MG EC","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":""}]}]}