{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JULIAN BRAY","gend":0,"add":"450 IRIS LN","city":"DANVILLE","state":"VA","zip":"24540-9998","dob":"1984-11-19","age":"","mstatus":"","insh":"1956157*01","cliId":"","pno":4346888330,"cno":4346888330,"email":"","ename":"","eno":"","pphy":"ADAMS, DAVID MD","ppno":4348573600,"pcpadd":"414 PARK AVE","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24541-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4348573601,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J44.9","F31.9","F33.9","F39.","S06.2X9S","F41.1","M25.521","V62.84","F41.9","S61.419A","S61.401D","F17.200","L84.","Z88.5","Z88.0","Z91.018","M79.642","S62.639A","L03.90","H17.89","H52.222","H25.11","Z20.822","J02.9","T63.444A","Z20.828","F33.1","F10.20","F19.94","S61.411A","S69.92XA","S60.512A","R03.0","Z72.0","D64.9","F10.10","M06.4","M54.9","R07.81","D50.9","Z79.899","F10.129","N39.0","S50.01XA","S80.01XA","S61.401A","F17.210","I25.2","V62.85","F31.30","F60.3","Z91.14","Z91.51","G47.00","H20.021","H18.20","M25.561","M70.31","S83.91XA","S86.911A","R09.81"],"date":["2023-03-19","2022-12-27","2022-08-04","2022-08-04","2022-03-03","2022-10-18","2021-01-28","2021-01-10","2021-01-10","2021-05-20","2021-06-30","2021-06-30","2021-06-30","2022-12-26","2022-12-26","2021-06-30","2022-07-26","2021-07-27","2021-07-27","2022-07-25","2022-07-25","2022-07-25","2022-12-26","2022-11-30","2022-08-11","2021-01-09","2023-01-03","2023-01-03","2021-01-15","2021-06-30","2022-07-26","2022-07-26","2022-07-26","2022-07-26","2022-10-18","2022-10-18","2022-10-18","2023-01-16","2023-01-16","2022-02-11","2022-12-26","2022-12-26","2022-12-26","2021-02-04","2021-02-04","2021-07-07","2022-12-28","2022-12-26","2022-12-28","2022-12-28","2022-12-28","2022-12-28","2022-12-28","2022-12-28","2021-01-22","2021-01-22","2021-01-28","2021-01-28","2021-01-28","2021-01-28","2022-11-30"],"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":[["","67877032105","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","35046000156","CA\/MG\/ZN","TAB ","60","Select","Select",""],["","59651039360","BUSPIRONE","TAB 30MG","60","Select","Select",""],["","60258018201","FERROUS FUM","TAB 324MG","60","Select","Select",""],["","65862019401","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","80681009800","VITAMIN B-1","TAB 100MG","30","Select","Select",""],["","59746017306","PREDNISONE","TAB 10MG","30","Select","Select",""],["","43598016605","OLANZAPINE","TAB 10MG","30","Select","Select",""],["","43547040610","CLONAZEPAM","TAB 0.5MG","60","Select","Select",""],["","67877022401","GABAPENTIN","CAP 400MG","60","Select","Select",""],["","47335070713","TOPIRAMATE","TAB 25MG","30","Select","Select",""],["","11534016503","FOLIC ACID","TAB 1MG","30","Select","Select",""],["","69097015915","MELOXICAM","TAB 15MG","30","Select","Select",""],["","47781060730","DISULFIRAM","250 MG","30","Select","Select",""],["","53489012002","DOXYCYCL HYC","TAB 100MG","14","Select","Select",""],["","11917004959","HYDROCORT","CRE 0.01","56","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","13107003134","MIRTAZAPINE","15 MG","30","Select","Select",""],["","68462022001","LITHIUM CARBONATE","150 MG","60","Select","Select",""],["","68382011405","RISPERIDONE","1 MG","30","Select","Select",""],["","59651039205","BUSPIRONE HCL","15 MG","60","Select","Select",""],["","47335032688","NALTREXONE HCL","50 MG","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":""}]}]}