{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LYRIC PEREZ","gend":1,"add":"292 MUD STREET","city":"CONCORD","state":"VA","zip":"24538-2361","dob":"1995-05-22","age":"","mstatus":"","insh":4471679,"cliId":"","pno":4344063890,"cno":4344207780,"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":"APT 8","add3":"","madd1":"292 MUD STREET","madd2":"APT 8","madd3":"","mcity":"CONCORD","mstate":"VA","mzip":"24538-2361","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O47.03","Z3A.33","O98.513","B00.9","K02.9","H92.01","Z3A.34","Z3A.37","O47.1","Z86.19","O60.03","Z3A.38","Z34.83","O47.9","O70.0","O80","O99.324","F12.10","O13.4","Z37.0","Z3A.39","Z83.3","F43.10","Z00.01","N76.89","A41.9","E87.1","A54.9","N12","A59.9","D64.9","E87.6","B96.20","Z20.822","N05.9","K56.7","N32.89","O23.03","O23.593","R50.9","R10.9","J02.0","J02.9","M54.5","S39.012A","O20.0","N91.2","N93.9","O20.9","R10.30","F17.210","Z3A.01","O26.851","R58","O02.9","O36.80X0","Z30.49","O99.613","N61.1","K08.89","R19.7","R11.2","R11.10","F31.2","N39.0","U07.1","R43.9","F17.200","F31.32","F32.A","F41.9","Z59.00","F31.0","F31.4","F33.1","F43.12","F31.60","R51","Z11.4","Z36.89","Z36.5","L03.90","S09.90XA","W17.89XA","Y92.22","Z34.01","Z12.4","Z11.3","Z34.81","R87.612","Z36.3","Z71.89","O46.92","O99.012","Z3A.17","Z34.82","Z13.32","Z13.89","Z23"],"date":["2020-02-10","2020-01-15","2020-01-15","2020-01-15","2021-07-29","2020-01-19","2020-01-23","2020-02-10","2020-02-10","2020-02-10","2020-02-20","2020-02-20","2020-02-20","2020-02-22","2020-02-22","2020-02-23","2020-02-22","2020-02-22","2020-02-22","2020-02-23","2021-07-29","2020-02-22","2020-06-18","2020-05-14","2020-06-17","2021-03-05","2021-03-05","2021-03-05","2021-03-05","2021-03-05","2021-03-05","2021-03-05","2021-03-02","2021-09-19","2021-03-02","2021-03-02","2021-03-02","2021-03-02","2021-03-02","2021-03-02","2021-03-02","2021-05-04","2021-05-04","2021-05-04","2021-05-04","2021-05-21","2021-05-12","2021-05-14","2021-05-14","2021-05-14","2021-08-25","2021-05-14","2021-05-14","2021-05-14","2021-06-04","2021-05-21","2021-05-26","2021-07-29","2021-08-25","2021-08-25","2021-08-25","2021-09-19","2021-08-25","2021-09-16","2021-09-19","2021-09-19","2021-09-19","2021-09-19","2021-11-05","2021-11-12","2021-11-12","2021-11-12","2021-12-05","2022-03-13","2022-02-16","2022-03-10","2022-04-05","2019-06-20","2019-07-30","2019-07-30","2019-07-30","2019-08-02","2019-08-02","2019-08-02","2019-08-02","2019-08-07","2019-08-13","2019-08-13","2019-08-13","2019-09-18","2019-11-12","2019-09-18","2019-09-25","2019-09-25","2019-09-25","2019-10-07","2019-11-12","2019-11-12","2019-11-12"],"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":[["","31722070430","VALACYCLOVIR","TAB 500MG","6","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","10","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","16","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","10","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","14","Select","Select",""],["","59762453802","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","00228212750","CLONIDINE","TAB 0.1MG","90","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","6.7","Select","Select",""],["","51991074790","DULOXETINE","CAP 30MG","60","Select","Select",""],["","63402030630","LATUDA","TAB 60MG","90","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","28","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","59762500801","MISOPROSTOL","TAB 200MCG","8","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","10","Select","Select",""],["","00093117410","PENICILLN","TAB 500MG","14","Select","Select",""],["","00904671980","ACETAMINOPHEN","TA B 325","90","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","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":""}]}]}