{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LATASHA   D MASON","gend":1,"add":"504 GREENWICH CIR","city":"FREDERICKSBURG","state":"VA","zip":"22408-9998","dob":"1976-08-16","age":"","mstatus":"","insh":"20068575*01","cliId":"","pno":"540\/621-2664","cno":"540\/621-2664","email":"","ename":"","eno":"","pphy":"HELENIUS, IRA M MD","ppno":"434\/924-1931","pcpadd":"1222 JEFFERSON PARK AVE 3RD FLOOR","pcpcity":"CHARLOTTESVILLE","pcpstate":"VA","pcpzip":22903,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/243-9282","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.00","F32.9","F19.10","E53.8","J30.89","Z00.00","G89.29","M25.531","J32.9","R07.89","K21.9","J34.89","J31.0","F33.2","F33.1","F31.4","F14.10","I10.","R10.32","M54.5","J45.909","R21.","N92.0","R73.9","M79.7","J32.4","NO DATA","E03.9","E03.8","F32.89","R42.","R53.1","M25.562","N89.8","Z01.411","R07.9","Z20.822","Z01.419","D25.9"],"date":["2021-03-04","2020-09-03","2022-03-18","2021-03-04","2021-03-04","2020-09-03","2022-08-08","2020-10-17","2021-09-23","2021-11-07","2021-12-09","2021-10-27","2021-10-27","2022-06-13","2022-11-21","2022-05-10","2022-11-21","2022-03-18","2021-06-03","2021-03-04","2021-03-04","2022-08-08","2021-10-22","2021-03-04","2021-03-04","2021-03-16","2021-12-09","2022-03-18","2021-12-09","2022-10-25","2022-03-18","2022-08-08","2022-08-08","2021-10-22","2021-10-22","2021-11-07","2021-11-07","2020-10-30","2020-10-30"],"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":[["","64764017130","DEXILANT","CAP 30MG DR","90","Select","Select",""],["","40985022309","B-12","TAB 500MCG","30","Select","Select",""],["","69097084615","CYCLOBENZAPR","TAB 10MG","90","Select","Select",""],["","65862020199","LOSARTAN","TAB 25MG","30","Select","Select",""],["","57237001999","DULOXETINE","CAP 60MG","30","Select","Select",""],["","67877022305","GABAPENTIN","CAP 300MG","180","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","90","Select","Select",""],["","16729018317","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","00186091706","PULMICORT","INH 90MCG","1","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","68180096503","LEVOTHYROXIN","TAB 25MCG","30","Select","Select",""],["","00555077902","MEDROXYPR","TAB 10MG","30","Select","Select",""],["","43598016405","OLANZAPINE","TAB 5MG","30","Select","Select",""],["","00536322301","CIT","TAB 200-250","90","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","00168020130","CLINDAMYCIN","SOL 0.01","30","Select","Select",""],["","52817023510","RAMELTEON","TAB 8MG","30","Select","Select",""],["","54629058501","VITAMIN","TAB 500MCG","90","Select","Select",""],["","69097015812","MELOXICAM","TAB 7.5MG","30","Select","Select",""],["","68462063945","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","13107003105","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","69097031987","BUDESONIDE","SUS 0.5MG\/2","60","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","20","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}