{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAWN   M KERNS","gend":1,"add":"367   CREST MOUNTAIN CIRCLE                                 ","city":"ELLISTON                      ","state":"VA","zip":"24087-4376","dob":"1985-09-19","age":"","mstatus":"","insh":4367497,"cliId":"","pno":5402068642,"cno":"","email":"","ename":"","eno":"","pphy":"LOIS, HILARY                                                ","ppno":5404437180,"pcpadd":"3700 S Main St,","pcpcity":"Blacksburg                    ","pcpstate":"VA","pcpzip":240607017,"pcpcounty":"","pcpid":"","pcpname":"ACADEMIC PRIMARY CARE ASSOCIATES LLC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"367 CREST MOUNTAIN CIRCLE","madd2":"                                                            ","madd3":"","mcity":"ELLISTON                      ","mstate":"VA","mzip":"24087-4376","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z79.899","F41.3","M79.7","G43.009","F33.41","F90.0","M25.562","J20.8","J45.21","R05","R09.89","F33.1","R11.0","R63.5","R76.8","M25.50","E55.9","E61.1","B86","J20.9","R21","J40","R68.2","F32.9","R53.82","N92.6","M54.16","R20.0","K21.9","F41.1","J01.20","R73.09","Z77.120","N39.0","Z20.822","R53.83","R42","R19.7","R63.0","R53.1","R51.9","F17.200","Z68.32","R10.84","L30.9","M54.2","F33.2"],"date":["2021-04-08","2020-10-09","2021-04-07","2021-09-15","2019-05-16","2021-09-15","2019-05-21","2019-06-14","2019-06-09","2020-04-12","2020-05-07","2021-09-15","2021-08-27","2019-12-30","2020-10-09","2020-10-09","2020-10-09","2019-12-30","2020-04-11","2020-04-12","2021-08-27","2020-04-12","2020-04-12","2020-04-12","2021-09-15","2020-10-09","2020-10-09","2021-08-24","2021-04-07","2021-09-15","2021-04-07","2021-04-30","2021-08-24","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-09-15","2021-12-15"],"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":[["","65862000899","METFORMIN","TAB 500MG","60","Select","Select",""],["","65862052301","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","65862052730","VENLAFAXINE","CAP 37.5 ER","30","Select","Select",""],["","68382000514","TOPIRAMATE","CAP 25MG","180","Select","Select",""],["","64764073030","TRINTELLIX","TAB 10MG","30","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","86790001930","SLOW","TAB 45MG","30","Select","Select",""],["","52817032000","BACLOFEN","TAB 10MG","30","Select","Select",""],["","29300035501","TRAMADOL","TAB 50MG","90","Select","Select",""],["","16729013600","CLONAZEPAM","TAB 0.5MG","45","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0.3","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","20","Select","Select",""],["","59417010710","VYVANSE","CAP 70MG","30","Select","Select",""],["","00456110130","VIIBRYD","KIT STARTER","30","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","13668013710","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","68382027101","ETODOLAC","TAB 400MG","60","Select","Select",""],["","00603533815","PREDNISONE","PAK 10MG","21","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","55111068405","IBU","TAB 800MG","30","Select","Select",""],["","65162003311","APAP\/CODEINE","TAB 300-30MG","15","Select","Select",""],["","65862019399","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","68180029603","DULOXETINE","CAP 60MG","30","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","65862064163","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","64380071306","BENZONATATE","CAP 200MG","30","Select","Select",""],["","43292055540","VITAMIN","TAB COMPLEX","30","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","45802026937","PERMETHRIN","CRE 0.05","60","Select","Select",""],["","63402030230","LATUDA","TAB 20MG","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":""}]}]}