{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KEITH A HARRIS","gend":0,"add":"111 ROBIN LN","city":"MADISON HEIGHTS","state":"VA","zip":"24572-9998","dob":"2001-06-22","age":"","mstatus":"","insh":"20073554*01","cliId":"","pno":4342219480,"cno":4342219480,"email":"","ename":"","eno":"","pphy":"KOZAK, BRENDA J NP","ppno":4349291400,"pcpadd":"134 ELON ROAD","pcpcity":"MADISON HEIGHTS","pcpstate":"VA","pcpzip":"24572-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4349290410,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K04.7","F90.2","E10.9","H52.13","M41.125","M54.6","R62.50","K00.6","M41.9","F41.9"],"date":["2022-05-13","2022-08-10","2022-01-25","2021-06-21","2021-06-29","2021-06-29","2021-06-29","2022-04-05","2021-05-17","2022-01-25"],"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":[["","00228306011","AMPHET\/DEXTR","CAP 20MG ER","30","Select","Select",""],["","54092038701","ADDERALL XR","20 MG","30","Select","Select",""],["","49035061246","ALLERGY RELF","TAB 10MG","30","Select","Select",""],["","69097083305","SERTRALINE","TAB 25MG","30","Select","Select",""],["","08290320119","BD PEN NEEDL","MIS 31GX5MM","100","Select","Select",""],["","00002879959","HUMALOG KWIK","INJ 100\/ML","15","Select","Select",""],["","16571082201","LORATADINE","10 MG","30","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA","400","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","65862085901","FAMOTIDINE","20 MG","90","Select","Select",""],["","50111056101","TRAZODONE","TAB 100MG","90","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","56","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","28","Select","Select",""],["","00536135301","VITAMIN D","3 50 MCG","30","Select","Select",""],["","40985027416","D3 SUPER STR","CAP 2000UNIT","90","Select","Select",""],["","00536135301","VITAMIN D3","CAP 50MCG","30","Select","Select",""],["","49035061295",""," ","90","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","15","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","00472016615","NYSTATIN","OIN 100000","15","Select","Select",""],["","11527070442","SOD FLUORIDE","GEL 1.1-5%","100","Select","Select",""],["","49502039475","INSULIN GLAR","INJ 100U\/ML","15","Select","Select",""],["","08627009111","DEXCOM G6","MIS RECEIVER","1","Select","Select",""],["","00088221905","LANTUS SOLOSTAR","100\/ML (3)","15","Select","Select",""],["","69097083412","SERTRALINE HCL","50 MG","76","Select","Select",""],["","42806015905","HYDROXYZINE HCL","10 MG","60","Select","Select",""],["","50111056101","TRAZODONE HCL","100 MG","90","Select","Select",""],["","43547030203","ARIPIPRAZOLE","2 MG","30","Select","Select",""],["","29300022019","MONTELUKAST SODIUM","10 MG","30","Select","Select",""],["","66993059702","DEXTROAMPHETAMINE-AMPHET ER","20 MG","30","Select","Select",""],["","08290320119","ULTRA-FINE MINI PEN NEEDLE","31 GX3\/16\"","200","Select","Select",""],["","53885024510","ONETOUCH ULTRA TEST STRIP","","100","Select","Select",""],["","00002879959","HUMALOG KWIKPEN U-","100 100\/ML","15","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":""}]}]}