{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JACOB   C CASTLE","gend":0,"add":"PO BOX 2093","city":"LEBANON","state":"VA","zip":"24266-9998","dob":"1990-09-09","age":"","mstatus":"","insh":"2165531*01","cliId":"","pno":"276\/202-5091","cno":"276\/202-5091","email":"","ename":"","eno":"","pphy":"EASTON, BRIAN THOMAS MD","ppno":"276\/889-3700","pcpadd":"495 EAST MAIN ST","pcpcity":"LEBANON","pcpstate":"VA","pcpzip":24266,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"276\/889-5505","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G40.89","R00.0","F33.3","F10.239","E87.1","V62.84","E87.6","F12.90","F17.210","F64.9","K70.10","S01.551A","Z63.9","G40.909","F43.10","F19.10","F10.229","R56.9","F10.20","G40.309","R53.1","F33.2","F33.1","F41.8","F17.200","F41.0","F10.10","F10.21","F41.1","F33.40","F12.10","Z20.822","G40.409","F32.9","I10.","R45.89","F32.3","Z86.59","H61.23","F51.04"],"date":["2020-01-29","2020-01-29","2021-10-05","2021-07-24","2021-07-24","2021-10-01","2020-11-07","2020-11-07","2021-07-23","2021-07-23","2020-11-07","2020-11-07","2020-11-07","2021-07-24","2020-11-07","2020-11-07","2020-11-07","2021-10-02","2021-11-16","2020-04-09","2021-07-23","2021-10-06","2021-11-16","2021-07-24","2021-10-02","2021-07-24","2021-10-04","2021-10-14","2021-10-14","2021-10-01","2021-10-01","2021-10-01","2020-02-04","2021-07-23","2021-10-14","2021-10-01","2021-10-14","2021-10-14","2021-10-14","2021-10-14"],"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":[["","43547028111","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","68382080510","TRAZODONE","TAB 50MG","30","Select","Select",""],["","13668021730","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","00406117001","NALTREXONE","TAB 50MG","30","Select","Select",""],["","00115166001","PROPRANOLOL","TAB 20MG","90","Select","Select",""],["","31722053705","LEVETIRACETA","TAB 500MG","60","Select","Select",""],["","57237017301","VENLAFAXINE","TAB 37.5MG","60","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","00555015904","CHLORDIAZEP","CAP 25MG","21","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":""}]}]}