{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CECELIA   B PATTERSON","gend":1,"add":"321 SMITH ST","city":"DANVILLE","state":"VA","zip":"24541-9998","dob":"1970-01-18","age":"","mstatus":"","insh":"7342012*01","cliId":"","pno":"434\/728-1543","cno":"","email":"","ename":"","eno":"","pphy":"DOLAN, FRANK NP","ppno":"434\/791-4122","pcpadd":"705 MAIN STREET","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"PIEDMONT ACCESS TO HEALTH SERVICES INC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/791-4126","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.33","NO DATA","D64.9","E83.39","N17.9","Z23.","R29.898","R41.3","R06.83","R53.81","G25.81","K65.8","E11.9","I10.","K59.04","K21.9","J30.9","R20.0","G62.9","M54.10","G56.20","E55.9","G47.09","R23.2","E44.1","D69.6","R82.71","I16.0","F17.210","Z20.828","Z90.710","Z79.891","Z79.84","Z68.26","Z09.","Z03.818","G56.21","M54.12","Z20.9","R09.02","H01.111","H01.114","J32.9","H66.92","Z72.0","H92.02","R35.0","H25.13","H52.4","Z12.31","Z13.6","L24.89"],"date":["2022-10-12","2020-12-12","2020-12-12","2020-12-12","2020-12-12","2021-06-17","2021-04-29","2022-08-10","2021-06-28","2021-04-29","2022-08-10","2020-12-09","2022-05-10","2020-12-09","2021-02-11","2022-01-06","2021-02-11","2021-02-11","2021-12-15","2021-06-21","2021-07-08","2022-08-10","2021-12-15","2021-12-15","2020-12-08","2020-12-08","2020-12-08","2020-12-08","2020-12-08","2021-01-05","2020-12-08","2020-12-08","2020-12-08","2020-12-08","2020-12-22","2021-01-05","2021-04-02","2022-08-10","2021-01-05","2022-04-13","2019-07-12","2019-07-12","2019-01-23","2019-01-23","2019-01-23","2019-01-23","2019-03-11","2022-05-10","2022-05-10","2022-01-06","2022-01-06","2022-04-21"],"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":[["","45802006335","TRIAMCINOLON","CRE 0.00025","15","Select","Select",""],["","51672130601","ALCLOMETASON","CRE 0.0005","15","Select","Select",""],["","51224011960","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","42806054701","VITAMIN","CAP 1.25MG","13","Select","Select",""],["","00781286810","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","90","Select","Select",""],["","68462018905","NAPROXEN","TAB 375MG","30","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","15","Select","Select",""],["","70461032103","FLUCLVX","INJ 2021-22","0","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","","DOK","CAP 100MG","","Select","Select",""],["","","AMITIZA","CAP 24MCG","","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":""}]}]}