{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GARY FREED JR","gend":0,"add":"279 POLLUCK ROAD","city":"LURAY","state":"VA","zip":"22835-9998","dob":"1966-12-04","age":"","mstatus":"","insh":"2282484*01","cliId":"","pno":"540\/742-3607","cno":"540\/742-3607","email":"","ename":"","eno":"","pphy":"SWITZER, DAVID MD","ppno":"540\/843-4624","pcpadd":"STE B 250 MEMORIAL DRIVE","pcpcity":"LURAY","pcpstate":"VA","pcpzip":22835,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"NORTHERN\/ WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/843-4626","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K92.2","K27.9","R10.9","D62.","K31.5","R11.0","R10.84","D50.0","R10.13","R93.3","D50.9","K21.0","K26.9","R06.02","K21.9","E87.6","R13.10","R94.31","R77.8","R06.00","R53.83","R19.5","R12.","R63.0","R63.4","Z87.11","K26.4","F17.210","Z82.49","K31.1","K28.9","M25.511","R00.0","K29.80","R79.89","K31.89","K20.9","R11.2","D64.9","Z87.19","R10.0","Z74.3","E44.0","K26.7","Z79.899","Z86.19","B96.81","T39.395A","I87.9","Z12.5","Z72.0"],"date":["2020-05-18","2022-05-20","2022-05-17","2020-05-18","2020-05-27","2020-05-27","2020-05-27","2020-03-03","2022-05-20","2020-03-03","2020-05-18","2020-05-27","2020-05-18","2020-05-17","2020-05-27","2020-05-18","2020-05-18","2020-05-17","2020-05-17","2020-05-18","2020-05-18","2020-05-18","2020-05-18","2020-05-18","2020-05-27","2020-05-18","2020-05-17","2020-05-27","2020-05-27","2020-05-27","2022-05-17","2022-05-17","2022-05-17","2020-03-02","2020-03-02","2020-03-03","2020-03-03","2022-05-20","2020-03-02","2020-05-27","2020-03-02","2020-03-02","2020-05-27","2020-05-27","2020-05-27","2020-05-27","2020-03-17","2020-03-04","2020-03-17","2020-03-17","2020-03-17"],"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":[["","50383077504","LIDOCAINE","SOL 2% VISC","300","Select","Select",""],["","00904683873","ALUM\/MAGNES\/","SUS SIMETH","150","Select","Select",""],["","68382004001","PROMETHAZINE","TAB 12.5MG","20","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","00527058601","DICYCLOMINE","CAP 10MG","30","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","00093221005","SUCRALFATE","TAB 1GM","120","Select","Select",""],["","42858010401","OXYCOD\/APAP","TAB 10-325MG","10","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","42","Select","Select",""],["","00781196260","CLARITHROMYC","TAB 500MG","28","Select","Select",""],["","46122035374","GNP","DIS 21MG\/24H","30","Select","Select",""],["","00536589688","NICOTINE","DIS 21MG\/24H","30","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":""}]}]}