{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHRISTINA   M SIMMONS","gend":1,"add":"15344 LONE PINE DRIVE","city":"TIMBERVILLE","state":"VA","zip":"22853-2732","dob":"2000-07-27","age":"","mstatus":"","insh":4310703,"cliId":"","pno":5408106985,"cno":5408106925,"email":"","ename":"","eno":"","pphy":"BRECH, KILIAN H","ppno":5403449213,"pcpadd":"21 Highland Ave SE, Ste 100","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240132218,"pcpcounty":"","pcpid":"","pcpname":"PHYSICIANS TO CHILDREN INC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"388 Rayann Ln","madd2":"","madd3":"","mcity":"Broadway","mstate":"VA","mzip":"22815-9576","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O99.89","R19.7","R51","O21.8","R22.0","Z87.891","Z88.0","Z91.018","Z3A.00","R11.2","O20.9","O36.80X0","Z3A.01","O02.1","N93.9","R42","O20.8","T14.8XXA","Z32.01","L30.9","O26.891","R10.2","Z34.90","Z34.81","O20.0","O21.0","Z3A.09","R10.13","Z3A.10","Z11.3","O9A.211","Y04.2XXA","S30.1XXA","Z3A.11","Y04.8XXA","R10.9","Z74.3","R10.84","Z36.89","Z3A.19","Z36.2","Z3A.23","O36.8320","O9A.212","S39.91XA","W22.8XXA","Y92.009","O99.891","M54.9","N85.8","Z3A.26","Z3A.25","R52","W19.XXXA","W01.0XXA","O26.892","R25.2","Z13.0","Z13.1","Z3A.30","Z79.899","O36.8130","Z3A.33","Z3A.34","O42.02","O42.92","G97.41","Z37.0","M41.9","O99.892","O9A.22","O89.4","O74.6","O70.0","Z20.822","L29.8","T36.8X5A","Z3A.37","G89.18","M54.41","M54.17","R29.898","R29.6","M54.42","G89.29","M51.17","N92.6","B37.3","N94.819","M54.5","Z11.59","M54.40","M41.26","M51.26","E05.90","J06.9","Z91.09","I35.9","R29.818","R40.1","R41.0","R20.0","R53.1","R47.1","G81.91","R51.9","R07.89","R07.9","Z53.09","I63.9","G44.89","R11.0","R45.7","G93.89","Z79.82","B35.9","Z28.21","O03.9","O46.90","N30.00","R05","J02.9","R14.0","O23.40","R11.10","O21.9","N39.0","B96.89","Z34.01","O26.841","W54.1XXA","S39.81XA","O99.341","F20.9","E86.0","O99.281","Z34.00","R10.31","Z3A.17","O23.42","K59.00","Z3A.20","O46.92","Z3A.24","O26.10","Z3A.28","O26.893","O9A.213","Z04.1","V89.2XXA","S31.609A","Z34.93","O60.03","O42.90","Z3A.36","N89.8","Z03.71","O36.5930","Z3A.38","O69.81X0","O80"],"date":["2020-06-19","2020-03-11","2020-03-11","2020-03-11","2020-03-11","2022-03-16","2022-03-16","2022-03-16","2020-04-13","2020-03-11","2020-03-13","2020-07-15","2020-06-19","2020-03-24","2022-03-16","2020-04-13","2020-04-13","2020-05-06","2020-06-01","2020-06-18","2020-07-10","2022-03-16","2021-01-28","2020-07-07","2020-07-10","2020-07-10","2020-07-10","2020-07-10","2020-07-15","2020-07-15","2020-07-18","2020-07-18","2020-07-18","2020-07-18","2020-07-18","2020-12-30","2020-07-18","2020-07-18","2020-09-17","2020-09-17","2020-10-15","2020-10-15","2020-10-29","2020-10-30","2020-10-29","2020-10-29","2020-10-29","2020-12-30","2020-10-29","2020-11-29","2020-11-05","2020-10-29","2020-10-29","2020-10-29","2020-10-30","2020-10-30","2020-11-05","2020-11-24","2020-11-24","2020-11-29","2021-01-19","2020-12-30","2020-12-23","2020-12-30","2021-01-20","2021-01-19","2021-01-19","2021-01-20","2021-05-18","2021-01-19","2021-01-19","2021-01-19","2021-01-19","2021-01-20","2021-10-11","2021-01-19","2021-01-19","2021-01-20","2021-01-21","2021-05-18","2021-05-18","2021-11-08","2021-04-29","2021-05-18","2021-06-21","2021-05-18","2021-06-28","2021-06-14","2021-06-28","2021-06-14","2021-06-28","2021-06-21","2021-06-21","2021-06-21","2021-06-28","2021-10-11","2021-10-11","2021-11-01","2021-11-01","2021-11-01","2021-11-01","2021-11-10","2021-11-08","2021-11-01","2021-11-10","2021-11-08","2021-11-08","2021-11-08","2021-11-01","2021-11-02","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-11-10","2021-11-10","2022-03-16","2022-03-16","2019-01-06","2019-01-06","2019-01-06","2019-01-06","2019-02-18","2019-02-18","2019-05-05","2019-02-18","2019-02-18","2019-03-18","2019-03-06","2019-03-13","2019-03-13","2019-03-28","2019-03-28","2019-03-28","2019-03-28","2019-04-09","2019-05-05","2019-05-05","2019-05-28","2019-05-05","2019-05-28","2019-06-25","2019-06-25","2019-07-24","2019-07-24","2019-09-26","2019-08-09","2019-08-09","2019-08-09","2019-08-09","2019-08-09","2019-09-08","2019-09-16","2019-09-16","2019-09-26","2019-09-26","2019-10-03","2019-10-03","2019-10-03","2019-10-03"],"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":[["","16571020210","DICLOFENAC","TAB 50MG DR","60","Select","Select",""],["","10702000709","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","51672129802","KETOCONAZOLE","CRE 0.02","30","Select","Select",""],["","68382004001","PROMETHAZINE","TAB 12.5MG","20","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","5","Select","Select",""],["","21922001704","CLOBETASOL","OIN 0.0005","30","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","52565012230","LIDOCAINE","CRE 0.04","30","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","43386016106","MISOPROSTOL","TAB 200MCG","4","Select","Select",""],["","49035056317","ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","15","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","16","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00093598627","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","24","Select","Select",""],["","00591299239","PHENADOZ","SUP 25MG","30","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":""}]}]}