{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  LIAGIBAAGNACS J ","gend":1,"add":"BPMAC 3TC LLE","city":"PALMYRA","state":"VA","zip":"22963-9998","dob":"2001-04-07","age":"","mstatus":"","insh":"7889110*94","cliId":"","pno":"73\/4341335-3","cno":"","email":"","ename":"","eno":"","pphy":"KINSELLA, LISSETTE NP","ppno":"434\/589-9030","pcpadd":"77 MARKET ST STE E","pcpcity":"PALMYRA","pcpstate":"VA","pcpzip":22963,"pcpcounty":"","pcpid":"","pcpname":"SMJMG - Sentara Palmyra Medical Associates","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O26.02","O43.192","Z3A.24","Z39.2","R11.0","F32.9","Z34.02","O34.01","Z3A.16","F33.1","Z20.828","O99.342","Z3A.20","O26.03","Z3A.29","O26.893","R10.2","O43.193","O34.03","Z3A.32","O32.1XX0","O36.5930","O34.593","Q51.28","Z3A.36","Z39.1","R20.0","R42.","R00.0","V23.5","Z3A.35","O36.5990","O32.1XX1","Z37.0","O99.344","O43.123","Z3A.37","Z87.891","Z83.3","Z82.49","Z81.8","S80.862A","W57.XXXA","L29.9","Z11.59","O42.013","Q51.10","O43.103","O26.899","Z30.015","Z00.00","S90.569A","J06.9","R21.","O34.592","Q51.20","R05.","Z30.09","Z30.011","Z3A.12","R07.89","M65.4","R68.89","J11.1","J02.9","M67.834","M67.833","M77.8"],"date":["2020-10-30","2020-10-30","2020-10-30","2021-03-10","2020-05-20","2021-01-23","2020-09-01","2021-03-10","2020-09-01","2021-08-05","2020-09-18","2020-09-30","2020-09-30","2020-11-30","2020-11-30","2020-12-23","2021-03-10","2021-03-10","2021-01-24","2020-12-23","2021-01-24","2021-01-24","2021-01-21","2021-01-23","2021-03-10","2021-01-25","2021-05-18","2021-05-18","2021-05-18","2021-01-13","2021-01-13","2021-03-10","2021-03-10","2021-01-24","2021-01-24","2021-01-23","2021-01-24","2021-01-23","2021-01-23","2021-01-23","2021-01-23","2021-09-10","2021-09-10","2020-06-03","2020-09-18","2021-01-24","2021-01-24","2021-01-24","2021-03-10","2021-03-10","2021-08-05","2021-09-07","2020-02-20","2021-09-10","2020-09-01","2020-09-01","2021-04-07","2021-04-09","2021-04-09","2020-08-04","2021-04-07","2019-07-19","2019-12-26","2019-12-26","2019-10-10","2019-11-24","2019-11-24","2019-09-17"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","68462030529","NORETHINDRON","TAB 0.35MG","84","Select","Select",""],["","","VENLAFAXINE","CAP 75MG ER","","Select","Select",""],["","00093767902","ETONOGESTREL","MIS ETHY EST","3","Select","Select",""],["","45802005505","TRIAMCINOLON","OIN 0.001","30","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","20","Select","Select",""],["","68001043897","LORATADINE","TAB 10MG","90","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00603533932","PREDNISONE","TAB 20MG","5","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","69842087651","CVS","TAB 325MG","30","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","180","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","15","Select","Select",""],["","","METRONIDAZOL","GEL 0.75%VAG","","Select","Select",""],["","","MONISTAT","CRE 0.04","","Select","Select",""],["","69238126601","OSELTAMIVIR","CAP 75MG","10","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":""}]}]}