{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GREGORY   S PALMER","gend":0,"add":"783 FOX RUN","city":"TROY","state":"VA","zip":"22974-9998","dob":"1963-07-27","age":"","mstatus":"","insh":"2206104*01","cliId":"","pno":"434\/531-0737","cno":"434\/531-0737","email":"","ename":"","eno":"","pphy":"MORSY, MOHAMED MD","ppno":"434\/243-1000","pcpadd":"500 RAY C HUNT DR FL 2","pcpcity":"CHARLOTTESVILLE","pcpstate":"VA","pcpzip":22903,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/244-7551","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J33.0","J32.0","J32.1","J32.2","J32.3","D62.","I10.","Z80.42","R73.03","Z23.","R97.20","J32.4","J33.9","S23.41XA","I25.10","E78.5","I21.4","H25.813","H52.4","M79.605","Z01.818","J32.9","R04.0","I25.2","Z79.82","Z98.890","S86.812A","N40.1","N13.8","J98.4","T39.015A","Z95.5"],"date":["2020-02-12","2020-02-12","2020-02-12","2020-02-12","2020-02-12","2020-03-03","2022-05-16","2021-10-06","2020-03-03","2020-03-03","2021-10-06","2020-03-30","2020-03-30","2021-03-31","2022-05-16","2022-05-16","2022-04-26","2020-07-30","2020-07-30","2021-09-21","2020-01-31","2020-02-21","2020-02-26","2020-02-20","2020-02-20","2020-02-20","2021-09-21","2021-10-06","2021-10-06","2020-02-26","2020-02-26","2020-02-27"],"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":[["","68645055254","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","00093505798","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","50742061510","METOPROL","TAB 25MG ER","30","Select","Select",""],["","43598043611","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","30","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","7","Select","Select",""],["","00186077760","BRILINTA","TAB 90MG","60","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","5","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","14","Select","Select",""],["","00245010810","FERROUS","TAB 325MG EC","4","Select","Select",""],["","57896070310","IRON","TAB 325MG","90","Select","Select",""],["","00024591801","DUPIXENT","INJ 200\/1.14","2","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":""}]}]}