{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KAYLA   M MONCADA","gend":1,"add":"1001 HOPEMAN PARKWAY                                        ","city":"WAYNESBORO                    ","state":"VA","zip":"22980-9998","dob":"1998-12-13","age":"","mstatus":"","insh":4195838,"cliId":"","pno":5404719083,"cno":"","email":"","ename":"","eno":"","pphy":"REID, JAMES R                                               ","ppno":5409421200,"pcpadd":"15 Pratts Run,Ste 103","pcpcity":"Waynesboro                    ","pcpstate":"VA","pcpzip":229806606,"pcpcounty":"","pcpid":"","pcpname":"UVA PRIMARY CARE WAYNESBORO","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"APARTMENT J4                                                ","add3":"","madd1":"1001 HOPEMAN PARKWAY","madd2":"APARTMENT J4","madd3":"","mcity":"WAYNESBORO                    ","mstate":"VA","mzip":"22980-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z34.03","R05","R52","R68.89","O47.03","O60.03","O26.893","Z3A.35","Z36.85","O36.8190","Z36.89","O36.8130","Z71.89","O34.211","O09.893","O98.52","B00.9","O99.333","F17.210","Z3A.38","Z37.0","O82","O34.219","G89.18","Z34.90","Z39.2","Z30.017","N91.0","J45.909","J30.2","F17.200","F10.20","Z86.59","F41.9","F42.9","F90.9","K59.09","Z00.00","Z23","F41.0","J10.1","J45.901","Z79.899","R50.9","R06.2","R07.89","R06.02","F43.21","F15.20","Z20.828","F43.10","R11.0","R53.83","N92.6","K21.00","J30.1","J45.20","Z01.419","R87.610","Z11.51","R87.810","Z11.8","A54.00","F33.1","A54.9","H10.31"],"date":["2019-02-22","2020-03-02","2019-01-23","2020-01-27","2019-02-17","2019-01-28","2019-01-28","2019-02-17","2019-01-30","2019-02-15","2019-02-15","2019-02-17","2019-02-19","2019-02-22","2019-02-22","2019-02-22","2019-05-01","2019-02-22","2019-02-22","2019-02-22","2019-02-22","2019-02-22","2019-02-22","2019-02-23","2019-03-04","2019-03-13","2019-04-15","2019-04-15","2019-05-01","2019-05-01","2019-05-01","2019-05-01","2019-05-01","2021-05-28","2019-05-01","2019-05-01","2019-05-01","2019-07-30","2019-07-30","2020-05-06","2020-03-02","2020-03-02","2020-03-02","2020-03-02","2020-03-02","2020-03-02","2020-03-02","2020-08-26","2021-12-29","2021-03-01","2020-12-30","2021-05-28","2021-05-28","2021-05-28","2021-05-28","2021-05-28","2021-05-28","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2021-06-02","2021-06-04","2021-11-15"],"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":[["","42806016105","HYDROXYZ","TAB 50MG","30","Select","Select",""],["","70436001002","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","50428042388","MELATONIN","CAP 10MG","30","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","90","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","90","Select","Select",""],["","68180029706","DULOXETINE","CAP 40MG","30","Select","Select",""],["","61314064305","TOBRAMYCIN","SOL 0.3% OP","5","Select","Select",""],["","00069046956","CHANTIX","TAB 1MG","60","Select","Select",""],["","31722070430","VALACYCLOVIR","TAB 500MG","90","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","13668013501","ESCITALOPRAM","TAB 5MG","60","Select","Select",""],["","50111043301","TRAZODONE","TAB 50MG","60","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","30","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","15","Select","Select",""],["","59779076678","PAIN","TAB 325MG","40","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","30","Select","Select",""],["","63824005632","MUCINEX","TAB 30-600ER","20","Select","Select",""],["","59779030603","CVS","POW ","510","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":""}]}]}