{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHARLES J BARBARDO","gend":0,"add":"278 MORGAN FORD ROAD","city":"FRONT ROYAL","state":"VA","zip":"22630-9998","dob":"1972-07-11","age":"","mstatus":"","insh":"2302678*01","cliId":"","pno":8042491845,"cno":8042491845,"email":"","ename":"","eno":"","pphy":"AKAN-ETUK, UDUAK ETUN MD","ppno":8047800840,"pcpadd":"2809 N AVE STE 206,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23222-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8044201140,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.32","F43.10","Z00.00","F99.","Z13.0","Z13.21","Z13.29","Z13.220","Z13.1","F12.20","F32.0","NO DATA","F11.20","Z71.51","Z79.899","F31.81","R41.82","R45.7","F31.9","V62.84","Z76.0","F32.9","R94.31","F14.10","F90.9"],"date":["2022-10-08","2022-10-08","2022-11-18","2022-11-18","2022-11-18","2022-11-18","2022-11-18","2022-11-18","2022-11-18","2022-12-27","2022-07-29","2022-08-08","2022-10-11","2022-09-19","2022-09-19","2022-12-27","2022-10-05","2022-10-05","2022-10-05","2022-10-06","2022-10-05","2022-10-06","2022-10-06","2022-10-11","2022-08-16"],"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":[["","69097081507","GABAPENTIN","CAP 400MG","60","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","43547030503","ARIPIPRAZOLE","TAB 15MG","30","Select","Select",""],["","00093354556","ATOMOXETINE","CAP 40MG","30","Select","Select",""],["","70436001102","BUPROPN HCL","TAB 300MG XL","30","Select","Select",""],["","70954002010","PRAZOSIN HCL","CAP 2MG","30","Select","Select",""],["","60505015701","BUPROPION","TAB 100MG","90","Select","Select",""],["","57664050083","MIRTAZAPINE","TAB 30MG","30","Select","Select",""],["","00115180401","HYDROXYZ PAM","CAP 50MG","60","Select","Select",""],["","43547026910","ROPINIROLE","TAB 0.5MG","30","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","50111056101","TRAZODONE HCL","100 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":""}]}]}