{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LA   BRITTNIE MAYS","gend":1,"add":"193 CHATLAINE AVENUE","city":"DANVILLE","state":"VA","zip":"24541-3868","dob":"1988-06-14","age":"","mstatus":"","insh":4365986,"cliId":"","pno":4347109938,"cno":"","email":"","ename":"","eno":"","pphy":"ULEP, REBECCA R","ppno":4347994495,"pcpadd":"142 S Main St, ","pcpcity":"Danville","pcpstate":"VA","pcpzip":245412922,"pcpcounty":"","pcpid":"","pcpname":"DANVILLE PHYSICIAN PRACTICES LLC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"APARTMENT B","add3":"","madd1":"193 CHATLAINE AVENUE","madd2":"APARTMENT B","madd3":"","mcity":"DANVILLE","mstate":"VA","mzip":"24541-3868","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O20.0","O20.9","Z3A.01","Z79.01","M25.571","O26.891","M79.10","Z3A.09","O99.211","Z32.01","Z3A.08","Z86.718","Z86.711","E66.01","Z68.42","R51","Z23","O9A.211","T50.B95A","R09.1","Z3A.11","T88.1XXA","M25.512","R07.81","O26.91","O88.211","I26.99","Z91.14","O99.511","J90","J18.9","O10.911","Z79.82","Z79.899","O99.891","R00.0","R06.02","Z3A.00","R94.31","I82.811","R07.89","R07.9","R11.2","J98.11","Z33.1","T88.6XXA","L50.9","Z3A.12","O10.912","O98.513","U07.1","Z3A.19","O35.0XX0","O99.212","Z20.828","O40.2XX0","Z3A.24","O09.93","O09.92","O10.913","O40.3XX0","O99.213","E66.9","Z3A.28","R73.09","Z3A.32","O36.8390","Z34.83","I82.409","O36.60X0","Z3A.36","O10.92","O99.214","Z37.0","Z3A.39","O76","Z30.430","Z87.59","O10.02","O16.3","P59.9","I22.2","J96.01","Z20.822","O85","J96.00","I21.4","O90.3","E44.1","O90.81","O99.53","I27.20","R79.1","E87.6","E80.6","Z88.1","R09.02","R79.81","I42.9","J06.9","S93.402A","N89.8","Z11.3","Z30.42","Z01.419","Z30.09","Z32.02","M54.5"],"date":["2020-09-12","2020-09-12","2020-09-12","2021-04-19","2020-09-15","2020-09-15","2020-09-15","2020-09-15","2020-10-05","2020-09-30","2020-09-16","2021-04-27","2021-04-19","2020-10-05","2020-09-16","2020-09-16","2021-02-25","2020-10-08","2020-10-03","2020-10-03","2020-10-08","2020-10-03","2020-10-03","2020-10-03","2020-10-03","2020-10-08","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2021-05-01","2020-10-13","2021-04-19","2020-10-05","2020-10-06","2020-10-06","2021-09-20","2020-10-05","2020-10-05","2020-10-06","2020-10-06","2021-05-01","2020-10-06","2020-10-06","2020-10-06","2020-10-08","2020-10-08","2020-10-13","2021-01-07","2020-12-01","2021-09-18","2020-12-01","2021-04-02","2020-12-01","2020-12-09","2021-01-07","2021-01-07","2021-01-27","2021-02-04","2021-04-02","2021-02-04","2021-04-02","2021-04-19","2021-02-04","2021-02-10","2021-03-04","2021-03-24","2021-03-24","2021-04-27","2021-04-02","2021-04-02","2021-04-19","2021-04-19","2021-04-20","2021-04-20","2021-04-19","2021-04-20","2021-04-19","2021-04-20","2021-04-20","2021-04-24","2021-04-27","2022-02-02","2021-09-28","2021-04-29","2021-04-27","2021-04-29","2021-04-29","2021-04-29","2021-04-29","2021-04-29","2021-04-29","2021-04-29","2021-04-27","2021-04-27","2021-04-27","2021-04-27","2021-04-27","2021-05-01","2021-09-20","2021-12-13","2019-04-09","2019-04-09","2019-04-09","2019-04-09","2019-04-09","2019-04-09","2019-09-06"],"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":[["","00363058714","ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","60","Select","Select",""],["","57237004105","PENICILLN","TAB 500MG","28","Select","Select",""],["","00955101210","ENOXAPARIN","INJ 120\/0.8","48","Select","Select",""],["","50458057830","XARELTO","TAB 15MG","60","Select","Select",""],["","00054429731","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","65862053820","LEVOFLOXACIN","TAB 750MG","3","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","30","Select","Select",""],["","00409272101","HEPARIN","INJ 10000\/ML","42","Select","Select",""],["","08290305945","1ML","MIS 27GX1\/2\"","42","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","14","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","21","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20.00","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","65862018501","CLINDAMYCIN","CAP 150MG","28.00","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":""}]}]}