{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOEL SMITH","gend":0,"add":"2004 WARDS FERRY RD APT 4","city":"LYNCHBURG","state":"VA","zip":"24502-9998","dob":"1986-05-23","age":"","mstatus":"","insh":"20056151*01","cliId":"","pno":"434\/473-4303","cno":"434\/473-4303","email":"","ename":"","eno":"","pphy":"HAYES, SHAWN MD","ppno":"434\/200-3908","pcpadd":"125 NATIONWIDE DRIVE","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":24502,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/200-5948","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Q87.40","I47.2","I71.00","Z95.2","I71.6","N39.0","I71.9","I35.0","Z79.01","I74.10","Z48.812","NO DATA","R53.83","R63.4","R12.","Z71.9","I10.","D64.9","I48.91","K21.9","F32.9","Z90.49","E56.9","R19.7","R10.9","Z20.822","J03.90","Z87.440","K29.70","K21.0","R10.13","K44.9","I71.2","F33.1","F41.1","K80.20","K80.10","Z23.","I71.03","N12.","Z78.9","R19.5","Z00.00","Z68.1","D22.5","D22.61","D22.62","D22.71","L57.8","Q67.6","Z11.3","Z11.4","Z92.29","H35.53","D22.72","L81.4","R50.9","K20.9","R14.0","R11.0","R19.8","R30.0"],"date":["2022-03-17","2022-03-17","2022-03-17","2022-09-15","2021-07-29","2022-01-24","2022-03-17","2022-01-24","2022-07-14","2020-01-27","2020-01-27","2022-07-08","2020-05-19","2020-05-19","2020-05-19","2020-05-19","2022-08-08","2021-02-05","2021-08-19","2021-08-05","2020-07-22","2020-07-22","2020-07-22","2020-08-24","2020-08-24","2021-12-12","2021-12-12","2022-04-04","2020-01-28","2020-01-13","2020-01-13","2020-01-13","2020-01-27","2022-08-08","2022-08-08","2020-02-21","2020-02-21","2022-09-28","2020-07-17","2022-03-17","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2021-08-05","2021-08-05","2021-08-05","2021-08-05","2021-02-05","2021-08-19","2021-08-19","2022-07-08","2020-01-28","2020-01-28","2020-01-28","2020-01-28","2022-07-08"],"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":[]},{"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":[["","69452017173","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","27241002238","ZOLMITRIPTAN","TAB 5MG","6","Select","Select",""],["","65862001205","SERTRALINE","TAB 50MG","90","Select","Select",""],["","68645049659","CARVEDILOL","TAB 25MG","180","Select","Select",""],["","68382013706","LOSARTAN","TAB 100MG","90","Select","Select",""],["","51672403201","WARFARIN","TAB 5MG","45","Select","Select",""],["","60505009400","DOXAZOSIN","TAB 2MG","180","Select","Select",""],["","55111015834","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","61314001910","DORZOLAMIDE","SOL 2% OP","10","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","8","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","10","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","10","Select","Select",""],["","68382052842","CHOLESTYRAM","POW 4GM","378","Select","Select",""],["","62332000131","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","62559039020","VANCOMYCIN","CAP 125MG","56","Select","Select",""],["","52015008001","DIFICID","TAB 200MG","20","Select","Select",""],["","49281072010","FLUBLOK","INJ 2020-21","0","Select","Select",""],["","33332032001","AFLURIA","INJ 2020-21","0","Select","Select",""],["","00005197102","PREVNAR","INJ ","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":""}]}]}