{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DENISE HAND","gend":1,"add":"401 BOLINGBROOK CT","city":"PURCELLVILLE","state":"VA","zip":"20132-9998","dob":"1963-06-26","age":"","mstatus":"","insh":"20087796*01","cliId":"","pno":8032614026,"cno":8032614026,"email":"","ename":"","eno":"","pphy":"CIANCIARUSO, LAUREN DO","ppno":5403387116,"pcpadd":"740 EAST MAIN STREET","pcpcity":"PURCELLVILLE","pcpstate":"VA","pcpzip":"20132-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5403386671,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R55.","R42.","R00.0","R11.0","R11.11","G89.29","Z76.0","Z79.891","R53.83","C25.9","E44.0","J96.01","K92.0","D50.0","R60.9","S00.83XA","R57.8","K25.9","I85.00","C17.0","R94.31","K92.2","R60.0","D62.","G89.3","F45.42","R06.02","Z66.","I49.8","R53.1","Z72.0","M19.90","M79.7","Z79.899","D64.9","K86.89","K31.89","R10.9","R19.7","K92.1","K25.4","C25.0","R18.8","Z85.07","S01.81XA","I10.","F17.290","M79.89","Z80.1","Z51.11","Z95.828","R52.","Z51.5","F43.23","R03.0","NO DATA","E53.8","M15.9","Z45.2"],"date":["2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-11-25","2022-11-25","2022-11-25","2022-11-25","2023-02-19","2022-12-09","2022-12-19","2023-02-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2023-02-19","2023-02-19","2023-02-19","2023-02-19","2023-02-19","2022-11-28","2022-11-28","2022-12-08","2022-12-08","2022-12-08","2022-12-19","2022-12-19","2022-12-13","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-13","2022-12-13","2022-11-28","2022-12-09","2022-12-09","2022-11-25","2022-11-25","2022-11-25","2022-11-25","2022-12-08"],"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":[["","00032301613","CREON","CAP 36000UNT","420","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","120","Select","Select",""],["","00406831501","MORPHINE SUL","TAB 15MG ER","60","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":""}]}]}