{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRENDAN   G MCNEELY","gend":0,"add":"184 W SUNRISE DR","city":"DRY FORK","state":"VA","zip":"24549-9998","dob":"2004-11-10","age":"","mstatus":"","insh":"9704000*01","cliId":"","pno":"434\/203-4711","cno":"","email":"","ename":"","eno":"","pphy":"BAAH-OWUSU, NADA O MD","ppno":"434\/799-2111","pcpadd":"STE 2100 201 S MAIN ST","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24540,"pcpcounty":"","pcpid":"","pcpname":"DANVILLE PHYSICIAN PRACTICES LLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/799-2297","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C71.2","Z01.810","R00.1","I45.19","C71.9","Z48.811","Z92.3","Z98.890","E87.2","R47.01","E83.42","E87.6","I10.","G40.909","F41.1","F93.0","Z01.818","D49.6","F41.9","G93.9","R45.86","R56.9","Z08.","Z51.0","Z23.","R90.89","I63.9","G89.18","S23.3XXA","Z85.841","Z92.21"],"date":["2021-08-02","2021-04-05","2021-04-05","2021-04-05","2021-04-22","2021-04-22","2021-04-21","2021-08-02","2021-04-21","2021-04-21","2021-04-21","2021-04-21","2021-04-21","2021-04-21","2020-07-20","2020-07-20","2021-04-16","2021-04-21","2021-01-06","2021-08-02","2021-08-02","2021-08-02","2020-03-02","2019-06-18","2019-10-29","2019-04-11","2019-04-11","2019-04-12","2019-11-20","2019-12-02","2019-04-11"],"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":[["","","FLUOXETINE","TAB 10MG","","Select","Select",""],["","57664037718","TRAMADOL","TAB 50MG","30","Select","Select",""],["","11845014871","SENNA\/DSS","TAB 8.6-50MG","30","Select","Select",""],["","67877022210","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","68180011302","LEVETIRACETA","TAB 500MG","60","Select","Select",""],["","43386031214","GAVILAX","POW ","510","Select","Select",""],["","00591336905","BUT\/APAP\/CAF","TAB ","30","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","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":""}]}]}