{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CINDY   M ADAMS","gend":1,"add":"905 LANIER LN","city":"CHATHAM","state":"VA","zip":"24531-9998","dob":"2002-07-04","age":"","mstatus":"","insh":"8066671*01","cliId":"","pno":"434\/228-8107","cno":"434\/228-8107","email":"","ename":"","eno":"","pphy":"OWUSUYAW, VICTOR MD","ppno":"434\/791-2600","pcpadd":"129 BROAD STREET SUITE B","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"DANVILLE NEUROLOGY ASSOCIATES INC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/792-0918","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.1","F33.1","G47.00","G40.219","G40.909","E83.39","R51.9","R11.0","Z79.899","I49.9","I51.7","G47.63","R56.9","D72.829","N76.0","B96.89","N39.0","R11.2","F41.9","F45.8"],"date":["2021-12-21","2021-12-21","2021-10-14","2021-12-21","2021-11-17","2021-09-02","2021-09-02","2021-09-30","2021-09-30","2021-09-30","2021-09-30","2021-12-21","2021-11-17","2021-09-30","2020-11-28","2020-11-28","2020-11-28","2020-11-28","2021-05-11","2021-09-14"],"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":{"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":[["","","LAMOTRIGINE","TAB 100MG ER","","Select","Select",""],["","","ESCITALOPRAM"," ESCITALOPRAM ","30","Select","Select",""],["","","LEVETIRACETA"," LEVETIRACETA ","120","Select","Select",""],["","","ZONISAMIDE","CAP 100MG","","Select","Select",""],["","","MELATONIN"," MELATONIN ","30","Select","Select",""],["","71699020128","XCOPRI","PAK 12.5-25","28","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","","OXCARBAZEPIN","TAB 600MG","","Select","Select",""],["","","CIPROFLOXACN","TAB 500MG","","Select","Select",""],["","12496120803",""," ","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":[]}},{"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":""}]}]}