{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ASHLEY N ROBINSON","gend":1,"add":"2537 MORATTICO ROAD","city":"LANCASTER","state":"VA","zip":"22503-9998","dob":"1989-09-05","age":"","mstatus":"","insh":"2154732*01","cliId":"","pno":8048541965,"cno":8048541965,"email":"","ename":"","eno":"","pphy":"STONE, JESSICA NP","ppno":8044352651,"pcpadd":"402 NORTH MAIN STREET,","pcpcity":"KILMARNOCK","pcpstate":"VA","pcpzip":"22482-9998","pcpcounty":"","pcpid":"","pcpname":"Bon Secours Lively Medical Center","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8044352303,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N17.8","I10.","Z87.891","I16.1","I21.4","I50.31","NO DATA","N17.9","I11.0","I70.1","Z68.30","D50.9","I42.9","E87.6","Z20.822","I25.10","E78.5","E83.42","Z79.899","I51.7","R80.9","N18.9","I12.9","N18.4","I25.2","E78.2","F41.9","F51.04","Z68.29","N28.89","R73.09","R82.998","R09.81","R05.","I50.9","N05.1","E55.9","D63.1","U07.1","J02.9","R05.8","J06.9","R06.02"],"date":["2022-10-09","2022-12-06","2022-10-09","2022-10-15","2022-10-09","2022-10-09","2022-11-21","2022-12-06","2022-10-09","2022-10-09","2022-10-09","2022-10-09","2022-10-09","2022-11-07","2022-10-09","2022-10-09","2022-10-09","2022-11-07","2022-10-09","2022-10-09","2022-10-14","2022-12-06","2022-11-21","2022-11-21","2022-11-21","2022-11-07","2022-11-21","2022-11-07","2022-11-21","2022-10-09","2022-11-21","2022-11-21","2021-01-27","2021-01-27","2022-10-08","2022-12-06","2022-12-06","2022-12-06","2023-02-02","2023-02-02","2023-02-02","2023-02-02","2022-10-08"],"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":[["","81131009371","","","90","Select","Select",""],["","31722070090","LOSARTAN POTASSIUM","25 MG","30","Select","Select",""],["","53746051401","SPIRONOLACTONE","50 MG","60","Select","Select",""],["","00904759080","FEROSUL","325(65) MG","30","Select","Select",""],["","42806054701","VITAMIN D","2 1250 MCG","2","Select","Select",""],["","00093505798","ATORVASTATIN CALCIUM","80 MG","90","Select","Select",""],["","62175026232","NIFEDIPINE ER","90 MG","30","Select","Select",""],["","43547040111","FUROSEMIDE","20 MG","180","Select","Select",""],["","68382009405","CARVEDILOL","12.5 MG","60","Select","Select",""],["","00603533815","PREDNISONE","10 MG","21","Select","Select",""],["","62175026232","NIFEDIPINE","TAB 90MG ER","30","Select","Select",""],["","53746051505","SPIRONOLACT","TAB 100MG","30","Select","Select",""],["","68462026430","ROSUVASTATIN","TAB 40MG","30","Select","Select",""],["","00093505798","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","00536100901","FERROUS SULF","TAB 325MG","15","Select","Select",""],["","50111039801","HYDRALAZINE","TAB 10MG","90","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","60","Select","Select",""],["","81131009371","SV IRON","TAB 325MG","15","Select","Select",""],["","68645052254","SERTRALINE","TAB 50MG","30","Select","Select",""],["","31722070090","LOSARTAN POT","TAB 25MG","30","Select","Select",""],["","31604002612","IRON","TAB 325MG","30","Select","Select",""],["","00536100901","FERROUS SULF TAB","325MG","15","Select","Select",""],["","69315011710","FUROSEMIDE TAB","40MG","45","Select","Select",""],["","00093505798","ATORVASTATIN TAB","80MG","30","Select","Select",""],["","62175026232","NIFEDIPINE TAB","90MG ER","30","Select","Select",""],["","16729022701","SPIRONOLACT TAB","100MG","30","Select","Select",""],["","68382009405","CARVEDILOL TAB","12.5MG","180","Select","Select",""],["","68462026430","ROSUVASTATIN TAB","40MG","30","Select","Select",""],["","50111039801","HYDRALAZINE TAB","10MG","90","Select","Select",""],["","31604002612","IRON TAB","325MG","30","Select","Select",""],["","42806054701","VITAMIN D CAP","1.25MG","4","Select","Select",""],["","50111056001","TRAZODONE TAB","50MG","60","Select","Select",""],["","81131009371","SV IRON TAB","325MG","15","Select","Select",""],["","31722070090","LOSARTAN POT TAB","25MG","30","Select","Select",""],["","00904759080","FEROSUL TAB","325MG","30","Select","Select",""],["","68645052254","SERTRALINE TAB","50MG","30","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":""}]}]}