{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BARBARA T SIMMONS","gend":1,"add":"101 THRUSH ST 101 THRUSH ST","city":"DANVILLE","state":"VA","zip":"24540-9998","dob":"1972-03-18","age":"","mstatus":"","insh":"20034952*01","cliId":"","pno":4347931348,"cno":4347931348,"email":"","ename":"","eno":"","pphy":"TINNIN, TAMARA J NP","ppno":4345280005,"pcpadd":"925 VILLAGE HIGHWAY,","pcpcity":"RUSTBURG","pcpstate":"VA","pcpzip":"24588-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4345280004,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F79.","NO DATA","Q90.9","R01.1","E78.00","Q21.0","Z00.00","E03.9","I50.9","Z12.39","I10.","E78.5"],"date":["2023-01-11","2022-11-03","2022-11-03","2023-03-08","2022-11-03","2022-11-03","2021-03-10","2022-08-22","2021-06-03","2021-03-10","2022-08-22","2022-08-22"],"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":[["","43547040211","FUROSEMIDE TAB","40MG","30","Select","Select",""],["","59651000305","OMEPRAZOLE CAP","40MG","30","Select","Select",""],["","00378180010","LEVOTHYROXIN TAB","25MCG","30","Select","Select",""],["","70377002911","ATORVASTATIN TAB","40MG","30","Select","Select",""],["","53746051101","SPIRONOLACT TAB","25MG","60","Select","Select",""],["","53746051101","SPIRONOLACTONE","25 MG","60","Select","Select",""],["","00378180010","LEVOTHYROXINE SODIUM","25 MCG","30","Select","Select",""],["","43547040211","FUROSEMIDE","40 MG","30","Select","Select",""],["","59651000305","OMEPRAZOLE","40 MG","30","Select","Select",""],["","70377002911","ATORVASTATIN CALCIUM","40 MG","30","Select","Select",""],["","50111056001","TRAZODONE HCL","50 MG","30","Select","Select",""],["","69584084110","SOTALOL","80 MG","60","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","00378180010","LEVOTHYROXIN","TAB 25MCG","30","Select","Select",""],["","53746051101","SPIRONOLACT","TAB 25MG","60","Select","Select",""],["","72305010030","EUTHYROX","100 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":""}]}]}