{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAXON   C ELLIOTT","gend":0,"add":"92 BRADLEY COURT","city":"LYNCHBURG                     ","state":"VA","zip":"24502-6858","dob":"2003-06-05","age":"","mstatus":"","insh":4479470,"cliId":"","pno":4346601930,"cno":"","email":"","ename":"","eno":"","pphy":"DEVOLLD, KIMBERLY","ppno":4345822273,"pcpadd":"2321 Wards Rd,","pcpcity":"Lynchburg                     ","pcpstate":"VA","pcpzip":245022101,"pcpcounty":"","pcpid":"","pcpname":"LIBERTY MOUNTAIN MEDICAL GROUP","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"92 BRADLEY COURT","add3":"","madd1":"92 BRADLEY COURT","madd2":"","madd3":"","mcity":"LYNCHBURG                     ","mstate":"VA","mzip":"24502-6858","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J02.9","F90.2","J06.9","J01.90","J20.9","R68.89","J02.0","N50.89","R00.1","H00.014","R19.7","L70.0","Z20.828","R05","D17.0","L72.0","Z51.81","D23.39","D36.9","J34.89","J93.83","F12.90","Z88.1","R07.89","J93.9","R07.9","Z46.82","J93.11","J43.9","J93.82","F90.9","Z79.899","R93.89","R91.1","J98.11","G89.12","J98.4","R06.89","F17.200","Z98.890","Z20.822","N48.5","Z11.3","Z87.09","Z63.4","R09.89","Z09","G08","Z79.01","Z86.718","K52.9","I80.8","I82.C12","J32.9","R09.81","Z86.79","R63.4","B34.9","R06.2","R52","R06.02"],"date":["2020-03-03","2022-03-11","2020-01-10","2020-01-29","2020-02-06","2020-02-06","2020-03-03","2020-06-10","2021-07-08","2020-08-27","2020-10-26","2021-12-07","2021-03-23","2021-09-29","2021-08-10","2021-10-25","2021-07-08","2021-07-08","2021-12-07","2021-08-08","2021-09-23","2021-09-21","2021-09-30","2021-09-30","2021-10-08","2021-09-21","2021-10-08","2021-09-24","2021-09-21","2021-09-21","2021-09-23","2022-03-11","2021-09-22","2021-09-23","2021-09-23","2021-09-24","2021-09-24","2021-09-30","2021-09-30","2021-09-30","2022-01-11","2022-01-05","2022-01-05","2022-03-17","2022-03-11","2022-03-17","2022-03-17","2019-02-18","2019-02-18","2019-02-18","2019-03-21","2019-05-13","2019-03-25","2019-05-08","2019-05-08","2019-05-13","2019-09-12","2019-11-11","2019-12-17","2021-09-30","2021-09-30"],"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","30.00","Select","Select",""],["","42806034301","AMPHET\/DEXTR","TAB 15MG","30","Select","Select",""],["","31722077701","ACYCLOVIR","TAB 400MG","30.00","Select","Select",""],["","69315030805","CIPROFLOXACN","SOL 0.3% OP","5","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00168020260","CLINDAMYCIN","GEL 0.01","60","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","10","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","54092038301","ADDERALL","CAP 10MG","30","Select","Select",""],["","63304061650","DOXYCYC","CAP 100MG","60","Select","Select",""],["","68645014059","FAMOTIDINE","TAB 20MG","28","Select","Select",""],["","49035028338","EQ","TAB 600MG","28","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","30","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","22","Select","Select",""],["","67405082508","BENZOYL","LIQ 5% WASH","237","Select","Select",""],["","00143314250","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","00472011745","TRETINOIN","CRE 0.00025","45","Select","Select",""],["","45802004064","SELENIUM","LOT 0.025","120","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","20","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","17478007035","ERYTHROMYCIN","OIN OP","3.5","Select","Select",""],["","42192060704","BROM\/PSE\/DM","SYP ","105","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","49035055203","COUGH","LIQ 5-100\/5","240","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","10","Select","Select",""],["","69543025216","VIRTUSSIN","SOL 100-10\/5","120","Select","Select",""],["","00548560300","ENOXAPARIN","INJ 60\/0.6ML","36","Select","Select",""],["","69452014320","BENZONATATE","CAP 100MG","21","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":""}]}]}