{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HANNAH ARNOLD","gend":1,"add":"167 HOLMES CT","city":"LYNCHBURG","state":"VA","zip":"24501-9998","dob":"1996-03-20","age":"","mstatus":"","insh":"2309589*01","cliId":"","pno":4349415568,"cno":4349415568,"email":"","ename":"","eno":"","pphy":"MARRACCINI, CHRISTINE A MD","ppno":4342397890,"pcpadd":"114 NATIONWIDE DR,","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":"24502-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4342379222,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O70.0","Z37.0","Z3A.40","O69.81X0","F31.9","F41.9","O99.344","O80.","R60.9","O36.5930","Z3A.32","O26.843","Z3A.34","R10.2","Z30.2","R32.","L20.89","Z3A.33","Z3A.35","Z3A.38","Z3A.39","N89.8","Z13.32","Z13.89","L20.84","L29.8","J01.90","NO DATA","M62.830","Z39.1","Z34.82","Z34.83","L55.9","Z3A.30","Z79.899","O99.824","Z3A.00","Z20.822","Z3A.36"],"date":["2021-05-09","2022-11-09","2021-05-09","2021-05-09","2022-11-08","2022-11-08","2022-11-08","2021-05-09","2022-08-10","2022-11-09","2022-09-22","2022-10-31","2022-10-07","2022-11-09","2022-11-09","2022-12-08","2022-07-26","2022-09-30","2022-10-14","2022-10-31","2022-11-09","2023-05-25","2022-07-11","2022-07-11","2023-03-17","2023-03-17","2023-05-27","2023-07-18","2022-08-17","2022-10-19","2022-09-29","2022-09-29","2022-07-26","2022-09-06","2022-11-08","2022-11-08","2021-05-09","2022-06-16","2022-10-20"],"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":[["","68462015713","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","67877025145","TRIAMCINOLON","CRE 0.001","454","Select","Select",""],["","29300041319","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","0","COMPOUND"," ","30","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","5","Select","Select",""],["","68645052254","SERTRALINE","TAB 50MG","30","Select","Select",""],["","50111033402","METRONIDAZOLE","500 MG","14","Select","Select",""],["","68645052254","SERTRALINE HCL","50 MG","90","Select","Select",""],["","16571020150","DICLOFENAC SODIUM","75 MG","60","Select","Select",""],["","21922001606","CLOBETASOL PROPIONATE","0.05 %","45","Select","Select",""],["","00143928501","AMOXICILLIN","875 MG","20","Select","Select",""],["","29300041319","CYCLOBENZAPRINE HCL","5 MG","30","Select","Select",""],["","55111014512","FLUCONAZOLE","150 MG","2","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":""}]}]}