{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHAUN  D COLE","gend":0,"add":"565 MOORE ST APT 202","city":"BRISTOL","state":"VA","zip":"24201-9998","dob":"1983-07-25","age":"","mstatus":"","insh":"20077551*01","cliId":"","pno":2766457430,"cno":2766457430,"email":"","ename":"","eno":"","pphy":"OLUBOWALE, KATIE C MD","ppno":2766695179,"pcpadd":"2195 EUCLID AVE","pcpcity":"BRISTOL","pcpstate":"VA","pcpzip":"24201-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2764668870,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F15.20","B20.","F17.200","NO DATA","R76.8","R50.9","Z20.822","J06.9","H66.92","F33.2","F41.1","F43.10","J20.9","Z21.","F17.210","Z87.898","F41.9","J20.8","Z72.0","J01.00","R09.81","R05.9","H66.91","J34.89","J02.9","J01.90","H92.03","Z53.21","R51.9","R63.4","R53.82"],"date":["2021-10-25","2022-01-05","2022-01-05","2022-11-26","2022-01-05","2021-09-26","2022-11-26","2022-08-24","2022-08-24","2022-09-29","2022-09-29","2022-09-29","2022-11-26","2022-11-26","2022-11-26","2021-09-26","2021-10-07","2022-11-26","2022-11-26","2021-11-27","2021-11-27","2022-07-19","2022-07-19","2022-07-19","2022-07-19","2022-07-19","2022-07-19","2022-11-22","2022-11-22","2022-08-26","2022-08-26"],"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":[["","61958250101","BIKTARVY","50-200-25","30","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","240","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","27808023302","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","20","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","40","Select","Select",""],["","11917004918","ACETAMIN","TAB 500MG","40","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":""}]}]}