{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GLENN  W THOMPSON","gend":0,"add":"3338 CAMPBELL AVE","city":"LYNCHBURG","state":"VA","zip":"24501-9998","dob":"1960-05-22","age":"","mstatus":"","insh":"2157536*01","cliId":"","pno":4342582953,"cno":4342582953,"email":"","ename":"","eno":"","pphy":"WADE, JAMES MD","ppno":4342003366,"pcpadd":"800 5TH STREET","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":"24504-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4342003106,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","F33.2","F41.1","Z72.0","B20.","NO DATA","F41.9","F17.210","R03.0","F32.9","Z71.6","Z20.822","F34.1","F43.10","F31.9","F19.10","R41.3","M25.511","G89.29"],"date":["2023-04-26","2022-10-31","2023-01-30","2023-01-30","2023-02-23","2022-11-17","2022-11-17","2022-11-17","2023-02-23","2021-12-30","2021-12-30","2022-01-10","2023-01-30","2023-01-30","2022-05-19","2021-03-04","2021-03-04","2021-03-04","2021-03-04"],"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":[["","65862035430","EMTR\/TENOFOV","TAB 200-300","30","Select","Select",""],["","69097044602","ATAZANAVIR","CAP 300MG","30","Select","Select",""],["","31722059730","RITONAVIR","100 MG","30","Select","Select",""],["","00074333330","NORVIR","TAB 100MG","30","Select","Select",""],["","43598016630","OLANZAPINE","10 MG","90","Select","Select",""],["","16729044316","BUPROPN HCL","TAB 150MG XL","270","Select","Select",""],["","61958070101","TRUVADA","TAB 200-300","30","Select","Select",""],["","27241009990","DULOXETINE","CAP 60MG","60","Select","Select",""],["","16729017101","AMITRIPTYLIN","TAB 10MG","30","Select","Select",""],["","12496120803","SUBOXONE","8 MG-2 MG","7","Select","Select",""],["","49281072110","FLUBLOK QUAD","INJ 2021-22","0","Select","Select",""],["","80777027399","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","11877001140","BINAXNOW COV","KIT HOME TES","2","Select","Select",""],["","49281042250","FLUZONE QUAD","INJ 2022-23","0","Select","Select",""],["","43598044774","NICOTINE TD","DIS 14MG\/24H","28","Select","Select",""],["","64380079508","CYPROHEPTAD","TAB 4MG","30","Select","Select",""],["","70954001910","PRAZOSIN HCL","1 MG","30","Select","Select",""],["","27241009990","DULOXETINE HCL","60 MG","60","Select","Select",""],["","65862035430","EMTRICITABINE-TENOFOVIR DISOP","200-300 MG","30","Select","Select",""],["","00781721664","BUPRENORPHINE-NALOXONE","2 MG-0.5MG","14","Select","Select",""],["","69097044602","ATAZANAVIR SULFATE","300 MG","30","Select","Select",""],["","16729044316","BUPROPION XL","150 MG","270","Select","Select",""],["","80777028299","MODERNA COVID BIVAL (","6Y UP)EUA 50 MCG\/0.5","0.5","Select","Select",""],["","00536589688","NICOTINE PATCH","21 MG\/24HR","28","Select","Select",""],["","58160082311","SHINGRIX","50 MCG\/0.5","1","Select","Select",""],["","16729018201","HYDROCHLOROTHIAZIDE","12.5 MG","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":""}]}]}