{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NARSHIMA   Y ROSS","gend":1,"add":"1111 14TH STREET","city":"LYNCHBURG                     ","state":"VA","zip":"24504-3411","dob":"1982-01-08","age":"","mstatus":"","insh":4469876,"cliId":"","pno":4342587723,"cno":"","email":"","ename":"","eno":"","pphy":"COMBS, KIMBERLY H","ppno":4348467374,"pcpadd":"2019 Tate Springs Rd Ste A,","pcpcity":"Lynchburg                     ","pcpstate":"VA","pcpzip":245011131,"pcpcounty":"","pcpid":"","pcpname":"PIEDMONT FAMILY PRACTICE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"1111 14TH STREET","add3":"","madd1":"1111 14TH STREET","madd2":"","madd3":"","mcity":"LYNCHBURG                     ","mstate":"VA","mzip":"24504-3411","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.0","R19.7","R11.0","A08.4","J45.901","I10","R10.9","J44.9","F17.210","M50.322","M25.512","R06.02","V49.40XA","Y93.89","Y92.488","M54.5","M25.562","Z79.899","Z88.1","S49.92XA","S19.9XXA","M47.812","S39.92XA","S89.92XA","Z01.411","Z01.419","J20.9","R09.89","E66.9","R06.89","R06.9","E11.59","E66.3","Z91.89","Z11.3","Z11.59","R53.83","F31.89","F39","J45.40","G47.00","K59.00","R04.2"],"date":["2020-03-02","2020-03-15","2020-03-15","2020-03-19","2020-06-05","2021-10-15","2021-09-27","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2020-06-05","2021-10-15","2021-10-15","2019-01-10","2019-01-10","2019-01-10","2019-06-25","2019-06-25","2019-10-27","2019-08-25","2019-08-25","2019-08-25","2019-08-25","2019-08-25","2019-08-30","2019-10-27","2019-10-27","2019-10-27","2019-11-24","2019-11-24"],"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":[["","13668011710","LOSARTAN\/HCT","TAB 100-12.5","30","Select","Select",""],["","57237010201","METOPROL","TAB 100MG","60","Select","Select",""],["","00085720601","DULERA","AER 100-5MCG","13","Select","Select",""],["","29300013905","DIVALPROEX","TAB 250MG DR","60","Select","Select",""],["","68180035302","SERTRALINE","TAB 100MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","16729017217","AMITRIPTYLIN","TAB 25MG","60","Select","Select",""],["","31722070210","LOSARTAN","TAB 100MG","30","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","30","Select","Select",""],["","68180016006","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00054001925","PREDNISONE","TAB 50MG","5","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","00378827052","ALBUTEROL","NEB 0.00083","75","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","50428231183","MAG","SOL CHERRY","592","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":""}]}]}