{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LOGAN EYLER","gend":0,"add":"42 TOPEZ LANE","city":"EVINGTON                      ","state":"VA","zip":"24550-2174","dob":"2004-07-09","age":"","mstatus":"","insh":4467403,"cliId":"","pno":4344776998,"cno":"","email":"","ename":"","eno":"","pphy":"THOMAS E DOBYNS MD","ppno":4345284312,"pcpadd":"4579 S Amherst Hwy,","pcpcity":"MADISON HEIGHTS               ","pcpstate":"VA","pcpzip":245725343,"pcpcounty":"","pcpid":"","pcpname":"THOMAS E DOBYNS FAMILY PRACTICE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"42 TOPEZ LANE","add3":"","madd1":"42 TOPEZ LANE","madd2":"","madd3":"","mcity":"EVINGTON                      ","mstate":"VA","mzip":"24550-2174","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F90.2","H81.12","H66.93","R10.13","K59.00","R14.3","S06.0X0A","F84.0","F90.9","Z77.22","R51","W18.39XA","Y93.89","Y92.89","S09.90XA","G93.0","J02.0","Z20.818","J02.9","J39.8","R55","S20.212A","R07.81","W19.XXXA","R74.8","M25.561","Z82.49","S89.91XA","S29.9XXA","S20.20XA","K31.89","G56.92","R20.0","M79.602","R10.11","R74.9","R79.89","R11.10","R11.2","G56.02","Z53.21","I95.9","R42","R53.1","R07.9","R00.0","B34.9","U07.1","R07.89","R06.02","R06.00","Z20.828","J06.9","F32.9","R45.851","T14.91XA","F90.0","F90.1","R44.0","F17.210","Z20.822","F33.2","F19.14","Z82.3","Z81.8","F39","H60.92","H92.09"],"date":["2021-11-17","2020-01-28","2020-02-15","2020-02-15","2020-02-15","2020-02-15","2020-02-24","2021-11-12","2020-02-24","2020-10-07","2020-02-24","2020-02-24","2020-02-24","2020-02-24","2020-02-25","2020-02-25","2021-11-02","2020-02-28","2021-12-09","2020-03-12","2020-10-07","2020-10-07","2020-10-07","2020-10-07","2020-10-07","2020-10-07","2021-11-11","2020-10-07","2020-10-16","2020-10-16","2020-11-12","2021-03-26","2021-01-13","2021-01-13","2021-01-26","2021-01-24","2021-01-24","2021-02-26","2021-03-04","2021-03-26","2021-03-29","2021-03-30","2021-03-30","2021-03-30","2021-10-11","2021-11-12","2021-09-11","2021-09-11","2021-10-11","2021-10-11","2021-10-11","2021-10-25","2021-10-27","2021-11-09","2021-11-11","2021-11-09","2021-11-12","2021-11-09","2021-11-09","2021-11-11","2021-11-11","2021-11-12","2021-11-11","2021-11-11","2021-11-11","2021-11-12","2021-12-09","2021-12-09"],"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":[["","00781261305","AMOXICILLIN","CAP 500MG","20","Select","Select",""],["","61314064610","NEO\/POLY\/HC","SOL 1% OTIC","10","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","14","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","6","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","24208041005","OFLOXACIN","DRO 0.3%OTIC","10","Select","Select",""],["","59267100003","PFIZER","INJ COVID-19","0.3","Select","Select",""],["","68645052154","SERTRALINE","TAB 25MG","15","Select","Select",""],["","68180072305","CEFDINIR","SUS 250\/5ML","100","Select","Select",""],["","68382004001","PROMETHAZINE","TAB 12.5MG","5","Select","Select",""],["","68382002210","ATENOLOL","TAB 25MG","30","Select","Select",""],["","58160084252","BOOSTRIX","INJ ","0.5","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59746012106","MECLIZINE","TAB 25MG","40","Select","Select",""],["","57237004101","PENICILLN","TAB 500MG","20","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":""}]}]}