{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"THOMAS R STRAUB","gend":0,"add":"99 KENDRICK AVE","city":"VERONA","state":"VA","zip":"24482-9998","dob":"1973-10-23","age":"","mstatus":"","insh":"2414669*01","cliId":"","pno":6784786665,"cno":6784786665,"email":"","ename":"","eno":"","pphy":"STOVALL, SAMARA R PA","ppno":5402132630,"pcpadd":"22 N MEDICAL PARK DRIVE","pcpcity":"FISHERSVILLE","pcpstate":"VA","pcpzip":"22939-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5402132631,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L98.9","R53.83","R35.8","F41.9","H91.93","Z21.","Z20.2","F19.21","Z86.69","Z13.220","B20.","Z91.89","H90.3","H93.13","F41.8","R41.3","F33.41","C44.41","B37.0","J02.9","A52.8","L82.1","D18.01","D48.5","N40.0","A53.9","R79.89","R35.1","G89.18","Z85.828","Z80.42","R39.12"],"date":["2021-11-22","2021-09-16","2021-09-16","2021-10-15","2021-09-16","2021-11-22","2021-09-16","2021-11-22","2021-09-16","2021-09-16","2023-03-07","2021-10-28","2021-11-10","2021-11-10","2021-12-22","2021-12-22","2021-09-30","2021-11-17","2021-09-30","2021-09-30","2021-09-30","2021-10-07","2021-10-07","2021-10-07","2023-03-07","2021-10-15","2021-10-15","2021-12-07","2021-11-17","2021-11-17","2021-12-07","2021-12-07"],"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":[["","65862042001","SMZ\/TMP DS","TAB 800-160","12","Select","Select",""],["","61958250101","BIKTARVY","50-200-25","30","Select","Select",""],["","68645052354","SERTRALINE","TAB 100MG","60","Select","Select",""],["","16714007601","TADALAFIL","TAB 10MG","15","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":""}]}]}