{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DARNELL SWANN","gend":0,"add":"3050 W MAIN ST RM 223","city":"DANVILLE","state":"VA","zip":"24541-9998","dob":"1961-05-25","age":"","mstatus":"","insh":"2199727*01","cliId":"","pno":5403437227,"cno":5403437227,"email":"","ename":"","eno":"","pphy":"LINGLE, KEVIN MD","ppno":5407312328,"pcpadd":"2900 LAMB CIR STE 201,","pcpcity":"CHRISTIANSBURG","pcpstate":"VA","pcpzip":"24073-9998","pcpcounty":"","pcpid":"","pcpname":"Sovah Heart & Vascular - Danville","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5406393950,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F10.188","H25.13","H40.1134","H40.1123","H40.1112","H57.00","R94.31","S00.01XA","H54.62","I10.","E78.00","Z87.891","V62.84","R44.3","F10.129","R42.","Z20.822","F32.9","F41.9","S09.90XA","F19.94","F10.20","Z98.41","H25.812","Z96.1","K40.20","M54.9","R52.","NO DATA","Z53.20","J06.9","R51.9","S00.81XA","M50.31","R09.81","W18.30XA","J44.1","R07.9","R07.89","F10.929","W19.XXXA","F33.2","F14.20","R10.9","K70.10","E87.1","S50.312A","E16.2","E87.6","R29.6","R06.02","E55.9","I11.0","I50.20","E78.5","F10.10","K76.0","Z91.81","I07.1","R93.1","R74.01","Y04.0XXA","Z59.00","I11.9","D64.9","E87.2","R00.0","J98.11","F17.210","Z53.29","F10.239","R09.02","R06.2","R40.4","R41.0","F32.3","R41.82","K73.9","F17.200","J96.01","R00.2","F10.120","W05.0XXA","R11.0","H25.813","E86.1","R74.8","I42.9","Z59.0","Z79.82","Z79.899","Z82.49","K70.40","I25.10","G89.29","K40.90","K59.00","K80.20","M25.552","G89.4","R53.81","R40.2411","H25.11","G93.49","R41.841","S72.115A","U07.1","R06.00","J80.","R53.1","S32.029A","S32.048A","Y99.9","M25.559","Z72.89","M54.41","S72.112A","M60.9","H40.9","E80.6","R06.9","J45.909","R45.6","R05.9","E80.7","R11.2","Z72.0","I50.9","S32.049A","S07.9XXA","M25.78","S00.211A","F14.10","K70.30","F14.14","R55."],"date":["2021-04-18","2021-05-05","2021-05-03","2021-06-28","2021-06-28","2021-06-28","2021-10-09","2021-08-13","2021-08-13","2023-01-24","2021-10-09","2021-09-01","2022-10-21","2021-08-13","2023-09-22","2021-11-09","2023-01-23","2021-11-09","2021-11-09","2021-11-28","2021-08-16","2022-10-04","2021-06-28","2021-06-28","2021-06-28","2021-11-12","2021-11-30","2021-11-11","2022-10-21","2022-08-04","2021-11-29","2021-11-29","2021-11-29","2021-11-29","2021-11-29","2021-11-29","2022-11-08","2023-01-24","2023-01-24","2022-02-11","2022-02-11","2022-10-27","2023-01-25","2023-01-20","2021-11-09","2021-10-19","2021-11-09","2021-11-11","2021-11-11","2021-11-09","2023-01-23","2021-11-11","2021-11-09","2021-11-27","2021-11-09","2023-08-15","2021-11-09","2022-07-28","2021-11-10","2021-11-10","2022-02-07","2021-11-11","2022-10-04","2022-02-07","2022-02-07","2022-02-07","2022-08-04","2022-02-07","2023-08-15","2022-02-07","2022-02-08","2022-02-07","2022-02-07","2022-11-08","2022-08-04","2023-01-24","2023-01-20","2021-10-19","2021-11-06","2021-11-27","2023-08-16","2021-11-27","2021-11-27","2022-02-08","2021-04-05","2021-09-29","2021-09-29","2021-10-09","2021-09-29","2021-10-09","2021-09-29","2021-09-29","2021-10-09","2021-10-09","2023-08-15","2021-10-09","2021-10-09","2021-10-09","2021-11-13","2021-11-17","2021-11-20","2022-11-08","2021-06-10","2021-08-12","2021-10-14","2021-11-13","2021-11-26","2023-01-23","2021-11-30","2021-11-30","2021-11-30","2021-11-30","2021-11-30","2021-10-09","2021-09-01","2021-11-06","2021-11-12","2021-11-12","2021-06-10","2021-10-09","2022-02-13","2022-10-04","2022-10-04","2023-01-23","2021-09-28","2021-09-28","2022-02-11","2021-11-26","2021-11-30","2022-07-28","2022-07-28","2022-07-28","2022-10-04","2023-08-15","2023-08-15","2023-08-15"],"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":[["","96295013576","MULTIVITAMIN TAB ADLT","50+","30","Select","Select",""],["","69097012715","AMLODIPINE TAB","5MG","30","Select","Select",""],["","69097082312","CITALOPRAM TAB","20MG","45","Select","Select",""],["","65162089703","ARIPIPRAZOLE TAB","5MG","30","Select","Select",""],["","96295013576","MULTIVITAMIN","TAB ADLT 50+","30","Select","Select",""],["","65162089703","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","69097012715","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","69097082312","CITALOPRAM","TAB 20MG","45","Select","Select",""],["","43598016405","OLANZAPINE","5 MG","30","Select","Select",""],["","65862019399","FLUOXETINE HCL","20 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":""}]}]}