{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AMBER   N BINNEY","gend":1,"add":"1468 AVON STREET","city":"CHARLOTTESVILLE","state":"VA","zip":"22902-6306","dob":"1993-01-01","age":"","mstatus":"","insh":4319930,"cliId":"","pno":4344651620,"cno":"","email":"","ename":"","eno":"","pphy":"DAVISON, JOHN S","ppno":4349757700,"pcpadd":"1800 Timberwood Blvd Ste A, ","pcpcity":"Charlottesville","pcpstate":"VA","pcpzip":229117544,"pcpcounty":"","pcpid":"","pcpname":"UVA FOREST LAKES HEALTH CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"1468 AVON STREET","madd2":"","madd3":"","mcity":"CHARLOTTESVILLE","mstate":"VA","mzip":"22902-6306","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R10.9","T78.49XA","Z20.2","R10.13","R11.2","Z88.0","Z88.1","O00.202","O20.9","Z87.59","O26.899","R10.2","Z3A.00","O00.102","O00.90","N92.0","Z30.41","Z11.3","Z20.822","A26.0","R51.9","Z00.00","Z01.419","Z33.1","R35.0","Z34.81","Z3A.01","Z36.9","O20.8","O99.891","R30.0","Z90.79","Z01.83","Z3A.09","Z34.80","Z13.79","Z31.5","Z3A.12","Z36.3","J01.90","L03.213","H10.9"],"date":["2021-01-11","2020-06-22","2020-10-05","2020-07-16","2020-10-01","2022-02-10","2022-02-10","2020-10-01","2022-02-10","2020-10-01","2020-09-30","2020-09-30","2020-09-30","2020-10-01","2020-10-05","2020-10-05","2020-10-05","2022-02-28","2021-09-09","2021-06-28","2021-09-09","2022-01-31","2022-01-31","2022-01-31","2022-02-07","2022-02-08","2022-02-10","2022-02-08","2022-02-10","2022-02-10","2022-02-10","2022-02-10","2022-02-28","2022-03-21","2022-02-28","2022-03-21","2022-03-21","2022-03-21","2022-03-21","2022-04-08","2019-01-31","2019-01-31"],"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":[["","00406055201","OXYCODONE","TAB 5MG","12","Select","Select",""],["","16714072002","FLUOXETINE","CAP 10MG","30.00","Select","Select",""],["","68462056529","NORGEST\/ETHI","TAB ESTRADIO","84","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","16729013616","CLONAZEPAM","TAB 0.5MG","20.00","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","29300022701","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","31722072610","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","16714065204","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","14.00","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","63","Select","Select",""],["","17478071310","OFLOXACIN","DRO 0.3% OP","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":""}]}]}