{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DONNA SPRINGER","gend":1,"add":"306 TANAGER DR","city":"STEPHENS CITY","state":"VA","zip":"22655-9998","dob":"1958-07-22","age":"","mstatus":"","insh":"2458121*01","cliId":"","pno":5405080260,"cno":5405080260,"email":"","ename":"","eno":"","pphy":"BYRD, JESSICA P MD","ppno":5406780792,"pcpadd":"SUITE 200 2913 VALLEY AVE","pcpcity":"WINCHESTER","pcpstate":"VA","pcpzip":"22601-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5406780795,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R90.0","G93.6","R29.898","F41.9","I10.","R53.1","R25.1","Z20.822","Z79.899","R93.0","R91.8","C34.81","F17.213","D49.6","C79.31","Z74.09","R53.81","G93.5","Z78.9","D64.9","D70.8","R11.2","E87.1","E66.9","L30.4","Z68.34","N18.2","I12.9","F10.21","NO DATA","F17.210","D75.1","Z74.1","H53.40","D72.829","Z98.42","Z72.0","Z45.2","Z51.11","Z51.12","B37.2","N61.0","Z74.3","D49.9","C34.31","Z98.890","R52.","C34.2","Z68.36","R47.1","C34.90","R21.","J84.10","J43.9"],"date":["2022-11-28","2022-12-08","2022-11-21","2023-03-13","2023-03-13","2022-11-22","2022-11-21","2022-11-21","2022-11-21","2022-11-22","2022-11-22","2023-04-13","2023-04-11","2022-12-08","2023-04-11","2022-12-08","2022-12-06","2022-12-08","2022-12-08","2023-03-13","2023-04-11","2023-03-13","2022-11-29","2022-12-08","2022-11-29","2022-11-29","2022-11-29","2022-11-29","2022-11-29","2022-11-29","2022-12-01","2022-11-29","2022-11-29","2022-11-29","2022-11-29","2022-11-29","2022-12-08","2022-12-16","2023-03-21","2023-03-21","2022-11-21","2022-11-12","2022-11-21","2022-11-23","2022-12-08","2022-12-08","2022-12-08","2022-11-23","2022-11-21","2022-11-21","2022-12-01","2022-11-12","2023-04-05","2023-04-05"],"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":[["","53746036110","FOLIC ACID","1 MG","30","Select","Select",""],["","33342006707","OLANZAPINE","2.5 MG","16","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","6","Select","Select",""],["","70954068910","PROCHLORPERAZINE MALEATE","10 MG","20","Select","Select",""],["","00054418425","DEXAMETHASONE","4 MG","6","Select","Select",""],["","70436015301","POTASSIUM CHLORIDE","20 MEQ","3","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":""}]}]}