{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SAVANAH   R BRYAN","gend":1,"add":"15   ASHBURN LANE                                           ","city":"WAYNESBORO                    ","state":"VA","zip":"22980-8302","dob":"1994-01-23","age":"","mstatus":"","insh":4118496,"cliId":"","pno":5404717016,"cno":5408367931,"email":"","ename":"","eno":"","pphy":"DUNBAR, KATHLEEN S                                          ","ppno":5409498241,"pcpadd":"428 S MAGNOLIA AVE                                          ,                                                            ","pcpcity":"WAYNESBORO                    ","pcpstate":"VA","pcpzip":229803608,"pcpcounty":"","pcpid":"","pcpname":"CARILION FAMILY MEDICINE ASSOCIATED PHYSICIAN","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"15   ASHBURN LANE                                           ","add3":"","madd1":"15   ASHBURN LANE                                           ","madd2":"                                                            ","madd3":"","mcity":"WAYNESBORO                    ","mstate":"VA","mzip":"22980-8302","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F23","F15.10","G47.00","Z72.0","F29","F33.1","F41.1","F60.3","Z00.00","F17.200","H65.92","F41.9","S19.9XXA","S49.91XA","S09.90XA","S40.021A","M54.2","Y04.8XXA","S19.80XA","Z71.6","R68.89","Z79.899","J06.9","L70.9","E04.9","J01.90","F17.210","R05","F90.9","R07.9","F32.9","F12.10","R00.0","F34.9","Z59.0","R45.1","F20.9","Z00.8","F20.89","F25.9","Z91.128","Z11.59","S81.012A","W19.XXXA","S81.012D","I10","R20.2","S81.819A","Z20.2","Z03.818","Z76.0","G40.909","Z86.69","F90.2","Z04.6","F15.259","R41.844","Z20.828","R45.850","F15.959","S00.12XA","R51.9","R22.0","Y93.9","S00.11XA","S02.2XXA","N89.8","S09.93XA","Y08.89XA","T14.90XA","N72","N76.0","Z86.19","R35.0","R30.0","M54.5","L29.9","R21","F25.1","F15.159","Z91.14","R46.2","L01.00","Z20.822","F32.A","F39","H60.501","R22.32","N93.9"],"date":["2020-11-12","2020-10-28","2020-11-13","2021-09-29","2020-05-27","2021-09-29","2020-04-16","2021-06-25","2020-01-15","2020-11-13","2020-01-15","2020-01-15","2020-01-21","2020-01-21","2021-01-19","2020-01-21","2020-01-21","2021-01-19","2020-01-21","2022-07-10","2020-10-29","2022-07-30","2020-02-11","2022-04-15","2020-03-19","2020-02-11","2022-11-29","2020-09-10","2020-02-25","2020-02-27","2022-07-10","2020-03-07","2020-03-07","2020-09-17","2021-07-30","2020-03-30","2022-11-29","2020-04-01","2020-04-01","2021-08-19","2020-07-26","2021-08-18","2020-07-19","2020-07-19","2020-07-19","2020-07-25","2020-08-11","2020-08-11","2020-09-10","2020-09-10","2020-08-26","2020-09-28","2020-08-26","2020-09-17","2022-07-30","2021-08-19","2020-11-12","2020-11-12","2020-11-12","2020-11-13","2021-01-19","2021-01-19","2021-01-19","2021-01-19","2021-01-19","2021-01-19","2021-01-19","2021-01-19","2021-01-19","2021-01-19","2021-06-25","2021-06-25","2021-06-25","2021-06-25","2021-07-30","2021-06-25","2021-07-30","2021-07-30","2022-11-30","2021-08-18","2021-08-19","2021-09-29","2022-05-30","2022-07-10","2022-07-10","2022-07-30","2022-08-02","2022-11-29","2022-11-29"],"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":[["","00781618667","CIPRO\/DEXA","SUS 0.3-0.1%","7.5","Select","Select",""],["","43547030603","ARIPIPRAZOLE","TAB 20MG","30","Select","Select",""],["","66993068530","OLANZAPINE","TAB 20MG","30","Select","Select",""],["","00093816201","QUETIAPINE","TAB 100MG","90","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","28","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","59651017301","DOXEPIN","CAP 10MG","30","Select","Select",""],["","60505283503","ATOMOXETINE","CAP 80MG","30","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","67877022205","GABAPENTIN","CAP 100MG","84","Select","Select",""],["","21922002107","PERMETHRIN","CRE 0.05","60","Select","Select",""],["","68180065208","DOXYCYC","CAP 100MG","14","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","43547034206","RISPERIDONE","TAB 2MG","30","Select","Select",""],["","57664049983","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","00781709459","ERY\/BENZOYL","GEL 5-3%","46.6","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","50428394374","CVS","GUM 4MGFRUIT","200","Select","Select",""],["","00168000615","TRIAMCINOLON","OIN 0.001","30","Select","Select",""],["","10702001250","HYDROXYZ","TAB 50MG","30","Select","Select",""],["","10370010150","BUPROPN","TAB 150MG XL","60","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","42","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":""}]}]}