{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHARON  D FERGUSON","gend":1,"add":"194 STEVENS ST","city":"APPOMATTOX","state":"VA","zip":"24522-9998","dob":"1957-02-14","age":"","mstatus":"","insh":"20027231*01","cliId":"","pno":4342299439,"cno":4342299439,"email":"","ename":"","eno":"","pphy":"QUARLES, MEREDITH S PA","ppno":5408872627,"pcpadd":"40 CHERRY GROVE RD","pcpcity":"MIDDLEBROOK","pcpstate":"VA","pcpzip":"24459-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5408862726,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z21.","Z79.899","I12.9","NO DATA","B20.","E66.9","R85.81","C53.9","Z72.0","Z87.411","Z87.19","Z11.3","R87.625","Z91.89","Z00.00","H40.1130","H40.039","H25.13","H40.1131","I63.9","Z29.9","I10.","E78.5","D84.9","E66.01","Z68.41","L30.8","E55.9","Z01.419","E78.2","N76.0","Z86.39","Z12.31","Z13.820","M85.851","Z23.","Z71.85","B96.89","M85.852","R60.9","Z85.41","N25.81","Z68.42"],"date":["2023-02-22","2022-05-03","2023-03-27","2023-03-27","2023-03-27","2022-11-07","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2022-05-09","2022-11-14","2023-03-27","2022-11-14","2023-03-27","2022-11-14","2023-03-23","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2023-03-30","2021-05-20","2021-10-27","2023-03-30"],"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":[["","49702023113","TRIUMEQ","600-50-300","30","Select","Select",""],["","68645045790","ENALAPRIL","TAB 20MG","180","Select","Select",""],["","81131031282","D3","CAP 2000UNIT","30","Select","Select",""],["","31604004070","VITAMIN D","3 25 MCG","90","Select","Select",""],["","59762033302","LATANOPROST","SOL 0.00005","2","Select","Select",""],["","54629005024","VITAMIN D3","TAB 1000UNIT","30","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","68382080601","TRAZODONE","TAB 100MG","30","Select","Select",""],["","00093505998","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","45802006436","TRIAMCINOLON","CRE 0.001","80","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","68682010510","NIFEDIPINE ER","30 MG","30","Select","Select",""],["","68645051654","AMLODIPINE BESYLATE","10 MG","30","Select","Select",""],["","43547040111","FUROSEMIDE","20 MG","180","Select","Select",""],["","00093505998","ATORVASTATIN CALCIUM","20 MG","30","Select","Select",""],["","31722070190","LOSARTAN POTASSIUM","50 MG","90","Select","Select",""],["","29300022705","METRONIDAZOLE","500 MG","14","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":""}]}]}