{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RICKEY   A GRANDSTAFF","gend":0,"add":"9501 AUBURN ROAD","city":"NOKESVILLE","state":"VA","zip":"20181-9998","dob":"1962-02-10","age":"","mstatus":"","insh":"20060145*01","cliId":"","pno":"571\/330-5573","cno":"","email":"","ename":"","eno":"","pphy":"MARINO, ANTHONY L MD","ppno":"540\/661-3004","pcpadd":"661 UNIVERSITY LANE STE B","pcpcity":"ORANGE","pcpstate":"VA","pcpzip":22960,"pcpcounty":"","pcpid":"","pcpname":"UNIVERSITY OF VIRGINIA PHYSICIANS GROUP","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/661-3060","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["A40.1","E87.2","L03.115","C64.9","I10.","G47.33","E11.9","Z11.59","R00.0","E78.00","Z79.899","A41.9","R26.89","D64.9","Z51.12","Z86.010","I51.7","R78.81","E11.620","Z51.11","M25.511","D12.6","Z12.11","Z09.","K64.8","C79.2","R93.89","F32.9","F41.9","G89.29","C64.2","Z51.81","Z79.82","V58.89","R65.10","M25.611","S46.011A","M75.101","M67.80","M12.811","R19.7","R19.02","R53.83","Z00.00","Z12.5","M25.50","Z85.528","Z98.890","Z23."],"date":["2020-06-13","2020-06-11","2020-06-19","2022-11-14","2022-10-21","2022-07-27","2022-11-14","2020-06-11","2020-06-11","2021-09-30","2020-06-11","2020-06-11","2020-09-23","2020-09-23","2021-07-09","2021-07-29","2020-06-11","2020-06-13","2020-06-13","2021-01-08","2021-09-30","2021-03-31","2021-03-31","2021-07-29","2021-07-29","2020-02-07","2020-05-29","2021-09-30","2021-09-30","2021-09-30","2020-12-11","2021-06-30","2021-06-30","2020-03-06","2020-06-11","2019-11-07","2019-10-22","2019-10-18","2019-10-18","2019-10-18","2019-11-08","2019-09-06","2022-11-14","2022-10-21","2022-11-14","2022-07-14","2022-11-14","2022-11-14","2022-10-21"],"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":[["","59651026901","GLIPIZIDE","TAB 5MG","90","Select","Select",""],["","60505257808","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","23155010210","METFORMIN","TAB 500MG","60","Select","Select",""],["","","LISINOPRIL","TAB 10MG","","Select","Select",""],["","00093075210","ATENOLOL","TAB 50MG","30","Select","Select",""],["","00093585205","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","59267102504","PFIZER","INJ ADLT RTU","0","Select","Select",""],["","53885000810","ONETOUCH","MIS PLUS 33G","100","Select","Select",""],["","65162062710","TRAMADOL","TAB 50MG","28","Select","Select",""],["","52268001201","SUPREP","SOL PREP KIT","354","Select","Select",""],["","65702040810","ACCU-CHEK","TES AVIVA PL","100","Select","Select",""],["","50924097110","SOFTCLIX","MIS LANCETS","100","Select","Select",""],["","","LEVOFLOXACIN","TAB 750MG","","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}