{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JONATHAN FERRELL","gend":0,"add":"508 RISON ST","city":"DANVILLE","state":"VA","zip":"24541-9998","dob":"1966-11-02","age":"","mstatus":"","insh":"20056359*01","cliId":"","pno":"434\/228-6685","cno":"434\/228-6685","email":"","ename":"","eno":"","pphy":"MILAM, JAMES MD","ppno":"434\/791-4122","pcpadd":"705 MAIN ST","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/791-4126","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.22","N18.9","N39.0","H53.8","E78.00","F33.3","A41.9","NO DATA","N17.9","E87.3","E44.1","R65.20","K52.9","D64.9","J44.9","E78.5","F32.89","F17.210","R26.89","E87.6","E83.39","E86.0","Z79.4","E11.65","E11.42","E55.9","H40.013","E11.9","J41.0","R06.02","J30.2","Z72.0","F10.20","M54.5","Z01.89","Z20.822","F14.20","Z74.09","M17.0","M76.62","E10.65","E13.10","A09.","K42.9","R39.81","E10.10","G40.901","H40.023","H25.813","J96.01","J45.901","I12.9","E66.01","Z68.38","F17.200","Z91.14","F12.20","F32.9","Z03.818","V62.84","E16.1","E16.2","R73.9","R40.4","R56.9","G93.41","J96.00","L89.150","Z09.","E87.1","I10.","J45.909","N40.1","N39.498","E87.2","F33.2","R06.00","R20.0","R11.2","H40.1122","H40.1111","L60.0","L60.2","M79.674","M79.675","R65.21","J69.0","R57.0","E87.0","E44.0","B37.0","A51.0","B96.20","F29.","Z12.11","Z87.891","K59.00","Z01.812","Z01.810","E66.9","Z71.3","R09.02"],"date":["2020-02-04","2020-02-04","2022-10-07","2020-02-04","2022-06-30","2021-03-01","2022-10-07","2022-10-18","2022-10-07","2022-02-05","2022-02-05","2022-02-05","2022-02-05","2022-02-05","2022-06-17","2022-02-05","2022-02-05","2022-02-05","2022-02-05","2022-02-05","2022-02-05","2022-02-05","2022-06-17","2022-08-08","2022-08-08","2022-08-08","2022-08-19","2022-08-19","2021-04-14","2021-04-14","2021-04-14","2021-04-14","2021-06-28","2021-07-07","2021-07-26","2022-10-07","2022-03-07","2022-10-09","2022-10-09","2022-04-20","2022-01-28","2022-02-07","2022-02-05","2022-02-05","2022-10-09","2022-10-13","2022-10-19","2022-03-25","2022-03-25","2022-10-07","2020-02-04","2020-02-04","2020-02-04","2020-02-04","2020-02-04","2020-06-05","2020-09-08","2020-08-05","2020-08-28","2020-08-28","2022-10-07","2022-10-07","2022-10-07","2022-10-07","2022-10-07","2022-10-18","2022-10-18","2022-10-18","2020-02-20","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-08","2020-09-03","2022-06-17","2022-06-17","2022-02-05","2022-03-11","2022-03-11","2022-09-21","2022-09-21","2022-09-21","2022-09-21","2022-10-07","2022-10-07","2022-10-07","2022-10-07","2022-10-07","2022-10-07","2022-10-07","2022-10-07","2020-09-02","2022-06-28","2020-11-06","2022-06-28","2022-08-22","2022-08-22","2021-03-04","2021-06-18","2021-07-07"],"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":[]},{"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":[["","42806054701","VITAMIN","CAP 1.25MG","4","Select","Select",""],["","00406117003","NALTREXONE","TAB 50MG","15","Select","Select",""],["","00002143480","TRULICITY","INJ 1.5\/0.5","2","Select","Select",""],["","00904679489","ASPIRIN","CHW 81MG","90","Select","Select",""],["","00555015802","CHLORDIAZEP","CAP 5MG","6","Select","Select",""],["","23155065201","METRONIDAZOL","TAB 500MG","15","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","3","Select","Select",""],["","68180031902","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","54738003503","SODIUM","TAB 325MG","2","Select","Select",""],["","68382080510","TRAZODONE","TAB 50MG","30","Select","Select",""],["","11534016501","FOLIC","TAB 1MG","7","Select","Select",""],["","96295013737","FISH","CAP 1000MG","180","Select","Select",""],["","00378623101","CITALOPRAM","TAB 10MG","30","Select","Select",""],["","68382011414","RISPERIDONE","TAB 1MG","30","Select","Select",""],["","65862020199","LOSARTAN","TAB 25MG","45","Select","Select",""],["","00173086910","ANORO","AER 62.5-25","60","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","15","Select","Select",""],["","56151210301","PEN  NEEDLES","MIS 31GX5\/16","100","Select","Select",""],["","10572010001","PEG-3350","SOL ELECTROL","4000","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","65162046550","IBUPROFEN","TAB 600MG","28","Select","Select",""],["","49483034010","ACETAMIN","TAB 325MG","84","Select","Select",""],["","31604002518","MULTI","TAB \/IRON","15","Select","Select",""],["","56151172201","INSULIN","MIS 0.5\/30G","100","Select","Select",""],["","49502060561","PERFOROMIST","NEB 20MCG","60","Select","Select",""],["","68180011507","LEVETIRACETA","TAB 1000MG","120","Select","Select",""],["","00093406106","FORMOTEROL","NEB 20\/2ML","20","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","30","Select","Select",""],["","23155010210","METFORMIN","TAB 500MG","60","Select","Select",""],["","70436015157","ARFORMOTEROL","NEB 15\/2ML","60","Select","Select",""],["","96295013836","MULTIVITAMIN","TAB ADULT","15","Select","Select",""],["","60505614804","CEFTRIAXONE","INJ 1GM","3","Select","Select",""],["","60505267109","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","75826011410","PHENAZOPYRID","TAB 100MG","6","Select","Select",""],["","76204060001","IPRATROPIUM\/","SOL ALBUTER","90","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","57237017099","ROSUVASTATIN","TAB 20MG","30","Select","Select",""],["","56151014201","TRUEDRAW","MIS LANC DEV","1","Select","Select",""],["","47884017550","EASYMAX","TES ","100","Select","Select",""],["","67877022205","GABAPENTIN","CAP 100MG","15","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","40985021151","B-1","TAB 100MG","7","Select","Select",""],["","56151014401","TRUPLUS","MIS 30G","100","Select","Select",""],["","53885000810","ONETOUCH","MIS PLUS 33G","100","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","4","Select","Select",""],["","57599080000","FREESTY","KIT 2 SENSOR","6","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","08290320109","BD  PEN NEEDL","MIS 31GX8MM","100","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","00002871501","HUMULIN","INJ 70\/30","30","Select","Select",""],["","43598044874","NICOTINE","DIS 21MG\/24H","28","Select","Select",""],["","00002879759","HUMALOG","INJ 75\/25KWP","15","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","10","Select","Select",""],["","57237003105","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","08222440006","ULTICARE","PAD ALCOHOL","100","Select","Select",""],["","68382013210","TAMSULOSIN","CAP 0.4MG","30","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":""}]}]}