{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ELISHA L HALL","gend":1,"add":"206 HENRY ST","city":"GRETNA","state":"VA","zip":"24557-9998","dob":"1979-10-15","age":"","mstatus":"","insh":"2146515*01","cliId":"","pno":3215915613,"cno":3215915613,"email":"","ename":"","eno":"","pphy":"GATEWOOD, TINA PA","ppno":4347914122,"pcpadd":"705 MAIN ST,","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24541-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4347914126,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D50.9","F43.20","D51.9","K91.2","R09.82","K21.9","Z98.84","E53.8","R00.2","Z51.11","NO DATA","G89.4","Z79.891","Z51.81","L20.84","L91.0","M54.5","M54.9","R11.0","K59.09","F32.0","F41.1","E66.3","I47.1","Z34.90","E66.9","L29.8","L53.8","K82.8","L72.8","L70.0","O42.113","Z3A.32","G54.1","F41.9","Z98.0","R10.13","E55.9","O09.512","V23.89","Z3A.19","G89.18"],"date":["2023-04-07","2022-03-08","2023-06-02","2023-03-23","2021-08-03","2021-12-14","2023-03-23","2021-12-14","2021-08-25","2021-10-13","2023-02-06","2023-02-06","2023-02-06","2022-11-07","2021-10-13","2021-10-13","2021-08-10","2021-11-10","2021-12-14","2021-12-08","2023-01-09","2023-01-09","2023-03-23","2022-03-09","2022-03-09","2021-11-23","2021-02-08","2021-02-08","2021-08-25","2021-10-13","2021-10-13","2022-07-05","2022-07-05","2022-07-05","2021-10-11","2021-12-14","2021-12-14","2021-12-14","2022-04-04","2022-04-04","2022-04-04","2022-07-05"],"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":[["","31722095105","OXYCOD\/APAP","TAB 10-325MG","90","Select","Select",""],["","45802037632","AUG BETAMET","CRE 0.0005","50","Select","Select",""],["","00143962125","CYANOCOBALAM","INJ 1000MCG","1","Select","Select",""],["","45802026337","CLINDAMYCIN","MIS 0.01","60","Select","Select",""],["","43547028110","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","55111064505","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","08290309570","3ML LL SYRNG","MIS 25GX5\/8\"","1","Select","Select",""],["","24979003702","METOPROL SUC","TAB 25MG ER","30","Select","Select",""],["","52747062030","CONCEPT OB","CAP ","30","Select","Select",""],["","56151014401","TRUPLUS LANC","MIS 30G","100","Select","Select",""],["","56151014201","TRUEDRAW","MIS LANC DEV","1","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","50","Select","Select",""],["","13811053530","FOLIVANE-OB","CAP ","30","Select","Select",""],["","53885004401","ONE TOUCH","KIT VERIO FL","1","Select","Select",""],["","31722071310","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00904699880","DOCUSATE SOD","CAP 100MG","30","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","65862001205","SERTRALINE","TAB 50MG","30","Select","Select",""],["","29300022705","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","00168034646","TERCONAZOLE","CRE 0.004","45","Select","Select",""],["","13668013605","ESCITALOPRAM OXALATE","10 MG","30","Select","Select",""],["","00406052301","OXYCODONE-ACETAMINOPHEN","10MG-325MG","90","Select","Select",""],["","69452015120","VITAMIN D","2 1250 MCG","4","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":""}]}]}