{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANN   E ROLLER","gend":1,"add":"471 NEW HOPE AND CRIMORA ROAD","city":"WAYNESBORO","state":"VA","zip":"22980-9998","dob":"1960-01-31","age":"","mstatus":"","insh":"20066881*01","cliId":"","pno":"540\/363-2253","cno":"","email":"","ename":"","eno":"","pphy":"CARPENTER, SHAUN E DO","ppno":"540\/248-4487","pcpadd":"1 GREEN HILLS DR","pcpcity":"VERONA","pcpstate":"VA","pcpzip":24482,"pcpcounty":"","pcpid":"","pcpname":"AUGUSTA MEDICAL GROUP","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/248-5312","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["T80.212A","T80.219A","N30.01","C50.812","E87.6","Z17.0","Z01.810","T45.1X5A","D70.1","D64.81","B37.9","S21.209A","H25.13","H25.013","H25.11","M25.612","M25.611","I89.0","I34.0","I10.","I25.2","I08.1","I70.0","I08.8","K52.1","C77.3","D68.51","Z16.11","E83.42","B95.61","I25.10","B96.20","E78.5","D69.6","R73.9","R59.0","D05.12","Z92.21","Z90.13","Z88.6","Z88.1","Z91.040","Z88.8","Z91.048","Z79.82","Z79.899","Z80.3","Z80.9","C50.412","C50.912","L98.7","G89.28","Z96.1","Z23.","Z85.3","R23.8","K43.2","R63.4","R53.81","R35.0","L02.212","Z79.811","T80.218A","V58.89","C50.819","R07.89","R23.2","T81.49XA","Z92.3","R29.898","K43.9","N28.1","M62.08","T81.31XA","H25.12","K43.6","R19.4"],"date":["2020-06-15","2020-06-17","2020-06-17","2021-07-29","2020-06-17","2021-10-07","2020-06-16","2020-09-09","2020-09-09","2020-09-09","2020-11-13","2020-11-13","2020-12-07","2020-12-07","2021-01-05","2021-08-03","2021-02-01","2021-08-03","2021-07-01","2021-07-01","2021-07-01","2021-07-01","2021-07-01","2021-07-01","2020-06-15","2021-04-26","2020-06-15","2020-06-15","2020-06-15","2020-06-15","2020-06-15","2020-06-15","2020-06-15","2020-06-15","2020-06-15","2020-09-01","2020-10-26","2020-10-26","2021-10-28","2020-10-26","2020-10-26","2020-10-26","2020-10-26","2020-10-26","2020-10-26","2021-04-15","2020-10-26","2020-10-26","2021-10-07","2021-03-15","2021-11-10","2021-03-25","2021-08-02","2021-06-04","2021-08-12","2021-10-04","2021-11-10","2020-09-09","2020-09-09","2020-08-20","2020-10-26","2021-07-08","2020-06-15","2020-07-13","2021-10-27","2021-10-27","2021-10-27","2020-06-20","2021-04-15","2021-04-15","2021-11-10","2021-10-28","2021-10-28","2020-09-17","2021-01-19","2021-07-29","2021-07-29"],"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":[["","16729003510","ANASTROZOLE","TAB 1MG","90","Select","Select",""],["","69097081312","GABAPENTIN","CAP 100MG","1","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","00378456105","POT  CHLORIDE","TAB 10MEQ ER","60","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","6","Select","Select",""],["","00591207030","LIDO\/PRILOCN","CRE 2.5-2.5%","30","Select","Select",""],["","65862018830","ONDANSETRON","TAB 8MG","20","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","3","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","15","Select","Select",""],["","00713072637","MOMETASONE","CRE 0.001","45","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","14","Select","Select",""],["","00143211250","DOXYCYCL","TAB 100MG","20","Select","Select",""],["","16714069211","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","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":""}]}]}