{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRANDY M M BREEDEN","gend":1,"add":"411 KELLY ST","city":"HARRISONBURG","state":"VA","zip":"22802-9998","dob":"1985-01-21","age":"","mstatus":"","insh":"1882657*01","cliId":"","pno":5409649008,"cno":5409649008,"email":"","ename":"","eno":"","pphy":"MOSS, JONATHAN D MD","ppno":5408282634,"pcpadd":"200 HIGH ST,","pcpcity":"BRIDGEWATER","pcpstate":"VA","pcpzip":"22812-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5408286911,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S22.41XA","G35.","R33.9","NO DATA","R26.9","R29.898","F31.81","F41.1","Z20.822","V54.19","R21.","L60.0","B85.2","S60.221A","S90.31XA","S09.90XA","Z88.5","Z88.2","Z88.8","Z20.828","S22.41XD","F15.20","F41.9","F32.0","F12.10","E66.09","Z98.84","F17.200","Z98.1","N39.0","Z68.30","D50.8","L30.9","M79.641","E61.1","K90.9","E53.8","R09.81","R09.89","Z88.9","Z79.899","K91.2"],"date":["2021-05-17","2022-08-02","2022-07-30","2022-07-30","2022-07-30","2022-07-30","2021-02-18","2021-02-18","2021-04-19","2021-05-21","2022-09-26","2022-06-30","2022-12-02","2022-12-05","2022-12-05","2022-12-05","2022-12-05","2022-12-05","2022-12-05","2021-04-19","2021-05-24","2022-07-06","2022-07-06","2022-07-06","2022-07-06","2022-08-02","2023-08-08","2022-08-02","2022-08-02","2022-08-02","2022-08-02","2023-08-08","2022-07-07","2022-12-05","2023-03-24","2023-05-01","2023-08-08","2023-05-21","2023-05-21","2023-05-21","2023-05-01","2023-08-08"],"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":[["","42806015905","HYDROXYZ HCL","TAB 10MG","60","Select","Select",""],["","13668013701","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","65862048901","QUETIAPINE","TAB 25MG","60","Select","Select",""],["","70010049110","METFORMIN","TAB 500MG ER","90","Select","Select",""],["","43547030303","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","69584009406","BUSPIRONE","TAB 30MG","60","Select","Select",""],["","00115166003","PROPRANOLOL","TAB 20MG","60","Select","Select",""],["","59779076926","LICE TRTMNT","LIQ 0.01","118","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","8","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","30","Select","Select",""],["","65862050320","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","68180044102","CEPHALEXIN","SUS 250\/5ML","300","Select","Select",""],["","00093026215","FLUOCINONIDE","CRE 0.0005","15","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","6","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","25","Select","Select",""],["","63736024797","NIX COMPLETE","KIT LICE 1%","325","Select","Select",""],["","00143928501","AMOXICILLIN","875 MG","14","Select","Select",""],["","50228043605","NAPROXEN","500 MG","6","Select","Select",""],["","40985027113","VITAMIN B-","12 5000 MCG","30","Select","Select",""],["","60505058204","MOXIFLOXACIN","0.5 %","5","Select","Select",""],["","68462015713","ONDANSETRON ODT","4 MG","30","Select","Select",""],["","60505083305","AZELASTINE HCL","137 MCG","30","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","43598081115","CETIRIZINE HCL","10 MG","30","Select","Select",""],["","68180044102","CEPHALEXIN SUS","250\/5ML","300","Select","Select",""],["","59746000103","METHYLPRED TAB","4MG","21","Select","Select",""],["","13668013701","ESCITALOPRAM TAB","20MG","30","Select","Select",""],["","69584009406","BUSPIRONE TAB","30MG","60","Select","Select",""],["","68462010530","ONDANSETRON TAB","4MG","25","Select","Select",""],["","00093026215","FLUOCINONIDE CRE","0.05%","15","Select","Select",""],["","00378064205","PREDNISONE TAB","20MG","6","Select","Select",""],["","63736024797","NIX COMPLETE KIT LICE","1%","325","Select","Select",""],["","74312058911","B-","12 2500 MCG","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":""}]}]}