{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MATTHEW  W MIDKIFF","gend":0,"add":"767 STAFFORDSVILLE HILL ROAD HILL RD","city":"STAFFORDSVILLE","state":"VA","zip":"24167-9998","dob":"1995-04-10","age":"","mstatus":"","insh":"20069695*01","cliId":"","pno":5409229475,"cno":5409229475,"email":"","ename":"","eno":"","pphy":"DAVIS, MICHAEL ALAN DO","ppno":5403811882,"pcpadd":"10 HICKOK ST STE 101","pcpcity":"CHRISTIANSBURG","pcpstate":"VA","pcpzip":"24073-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5403821866,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C81.11","F33.1","C81.90","E66.9","Z92.21","Z68.35","Z20.822","F20.9","G89.3","E86.0","R11.2","H10.9","Z08.","Z85.71","Z92.3","E03.9","C81.10","Z45.2","Z85.72","M10.9","D72.828","E55.9","J18.1"],"date":["2023-02-08","2021-08-30","2021-04-30","2021-04-30","2021-07-02","2021-04-30","2023-01-19","2023-02-08","2023-01-24","2023-01-19","2023-01-19","2023-01-19","2021-07-02","2021-07-02","2021-07-02","2022-08-23","2023-02-01","2021-04-30","2021-04-30","2022-07-15","2023-02-08","2021-01-19","2023-02-08"],"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":[["","42806054701","VITAMIN D","CAP 1.25MG","4","Select","Select",""],["","00378104901","DOXEPIN HCL","CAP 10MG","90","Select","Select",""],["","13668022030","ARIPIPRAZOLE","TAB 20MG","30","Select","Select",""],["","31722094201","HYDROCO\/APAP","TAB 7.5-325","8","Select","Select",""],["","31722054301","INDOMETHACIN","CAP 50MG","15","Select","Select",""],["","70010000201","COLCHICINE","TAB 0.6MG","12","Select","Select",""],["","55111028130","LEVOFLOXACIN","750 MG","4","Select","Select",""],["","24208031510","POLYMYXIN B SUL-TRIMETHOPRIM","10000-1\/ML","10","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":""}]}]}