{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARK PAINTER","gend":0,"add":"480 MEADOWS FARM ROAD","city":"BLAIRS","state":"VA","zip":"24527-9998","dob":"1975-11-27","age":"","mstatus":"","insh":"1940913*01","cliId":"","pno":4347134506,"cno":4347134506,"email":"","ename":"","eno":"","pphy":"STEPHENS, AMBER L DO","ppno":4347994488,"pcpadd":"SUITE 201 109 BRIDGE STREET,","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24541-9998","pcpcounty":"","pcpid":"","pcpname":"Sovah Family Medical Residency Clinic","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4347736977,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.33","B02.9","F45.8","C20.","G62.0","C78.7","T45.1X5A","NO DATA","Z72.0","R31.29","N20.0","R97.0","Z23.","R91.1"],"date":["2022-04-02","2022-07-24","2021-05-28","2021-12-09","2021-06-10","2021-06-10","2021-06-10","2022-09-24","2021-05-28","2022-09-24","2022-09-24","2021-12-09","2021-12-09","2021-12-09"],"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":[["","00378064205","PREDNISONE","TAB 20MG","10","Select","Select",""],["","76385012450","METHOCARBAM","TAB 750MG","15","Select","Select",""],["","31722070530","VALACYCLOVIR","TAB 1GM","21","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","18","Select","Select",""],["","57237001401","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","68180086206","AZITHROMYCIN","500 MG","5","Select","Select",""],["","76385012450","METHOCARBAM TAB","750MG","15","Select","Select",""],["","00378064205","PREDNISONE TAB","20MG","10","Select","Select",""],["","31722070530","VALACYCLOVIR TAB","1GM","21","Select","Select",""],["","57237001401","TAMSULOSIN CAP","0.4MG","30","Select","Select",""],["","65862042005","SMZ\/TMP DS TAB","800-160","20","Select","Select",""],["","53746010901","HYDROCO\/APAP TAB","5-325MG","18","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":""}]}]}