{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KENDRA R WILLIAMS","gend":1,"add":"1144   STRATFORD ROAD","city":"LYNCHBURG","state":"VA","zip":24502,"dob":"1979-07-15","age":"","mstatus":"","insh":4640662,"cliId":"","pno":4342136677,"cno":"","email":"","ename":"","eno":"","pphy":"WU, VELYN","ppno":4342136677,"pcpadd":"2323 MEMORIAL AVE ,STE 10","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":24501,"pcpcounty":"","pcpid":"","pcpname":"LYNCHBURG FAMILY MEDICINE CENT","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/CHARLOTTESVILLE","aligned":"","ano":"","add2":"1144   STRATFORD ROAD","add3":"","madd1":"1144 STRATFORD ROAD","madd2":"","madd3":"","mcity":"LYNCHBURG","mstate":"VA","mzip":"24502-1038","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","E11.9","G43.009","M79.7","R53.81","Z11.4","R53.83","Z11.59","Z13.220","R05","G47.33","Z20.828","Z79.84","Z79.899","Z82.49","Z88.8","M54.5","L81.9","Z23","Z86.59","M47.816","M41.9","Q76.0","J02.9","J06.9","R68.89","M51.26","M51.27","M48.061","F31.9","F41.1","L68.9","L02.02","L20.84","L83","D22.61","D22.62","N83.209","M12.88","Z20.822","G43.909","K58.0","K21.9","R10.9","Z71.9","H10.11","H16.141","Z72.89","Z83.3","M54.2","M62.838","M50.30","M50.322","M50.323","M47.812","M54.12","M53.83","R20.2","M48.02","M25.512","M50.11","G95.89","M54.16","M47.22","M47.9","Z01.812","M51.36","Z01.811","M47.12","M50.01","E66.01","F32.9","Z68.37","Z88.5","Z47.89","R19.7","R19.4","N89.9","F31.32","R50.9","R05.9","H10.13"],"date":["2022-01-06","2022-01-31","2020-08-12","2021-09-03","2020-08-12","2020-08-12","2020-08-12","2021-08-26","2020-08-12","2020-08-13","2021-03-14","2020-12-08","2021-02-03","2021-09-03","2021-02-03","2021-03-14","2021-08-23","2021-01-13","2020-10-26","2020-10-26","2021-02-03","2020-11-20","2020-11-20","2020-12-08","2022-01-09","2020-12-10","2020-12-17","2020-12-17","2021-09-03","2022-02-09","2021-12-01","2021-01-13","2021-01-13","2021-01-13","2021-01-13","2021-01-13","2021-01-13","2021-01-15","2021-01-20","2021-08-26","2021-02-03","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-01-29","2021-01-29","2021-02-03","2021-09-03","2022-02-22","2021-03-23","2021-05-10","2021-03-23","2021-03-23","2021-06-14","2021-05-17","2021-05-17","2021-05-17","2021-09-03","2021-06-14","2021-09-03","2021-06-18","2021-08-23","2021-09-03","2021-08-23","2021-08-23","2021-08-23","2021-08-31","2021-09-03","2021-09-03","2021-09-03","2021-09-03","2021-09-03","2021-09-03","2022-02-22","2021-10-18","2021-11-22","2021-11-10","2021-12-15","2022-01-06","2022-01-09","2022-01-31"],"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":[["","69097081312","GABAPENTIN","69097081312 GABAPENTIN ","60","Select","Select",""],["","00143122701","DICYCLOMINE","00143122701 DICYCLOMINE ","180","Select","Select",""],["","65862085901","FAMOTIDINE","65862085901 FAMOTIDINE ","180","Select","Select",""],["","43547030303","ARIPIPRAZOLE","43547030303 ARIPIPRAZOLE ","30","Select","Select",""],["","31722070210","LOSARTAN","TAB 100MG","30","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","30","Select","Select",""],["","53746010901","HYDROCO\/APAP","53746010901 HYDROCO\/APAP ","5","Select","Select",""],["","69547035302","NARCAN","69547035302 NARCAN ","2","Select","Select",""],["","00591565810","CYCLOBENZAPR","00591565810 CYCLOBENZAPR ","10","Select","Select",""],["","45802048678","DOCUSATE","45802048678 DOCUSATE ","20","Select","Select",""],["","59746033990","LOSARTAN\/HCT","59746033990 LOSARTAN\/HCT ","90","Select","Select",""],["","63402030230","LATUDA","63402030230 LATUDA ","30","Select","Select",""],["","70710113908","FLUCONAZOLE","70710113908 FLUCONAZOLE ","30","Select","Select",""],["","00603233832","APAP\/CODEINE","TAB 300-30MG","18","Select","Select",""],["","67877025145","TRIAMCINOLON","67877025145 TRIAMCINOLON ","454","Select","Select",""],["","16571020106","DICLOFENAC","16571020106 DICLOFENAC ","60","Select","Select",""],["","69097015907","MELOXICAM","69097015907 MELOXICAM ","30","Select","Select",""],["","61314063136","NEO\/POLY\/DEX","61314063136 NEO\/POLY\/DEX ","3.5","Select","Select",""],["","67877019810","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","00603459321","METHYLPRED","00603459321 METHYLPRED ","21","Select","Select",""],["","60505025203","TIZANIDINE","60505025203 TIZANIDINE ","60","Select","Select",""],["","43199001401","HYOSCYAMINE","43199001401 HYOSCYAMINE ","30","Select","Select",""],["","59779030603","CVS","59779030603 CVS ","510","Select","Select",""],["","00168020230","CLINDAMYCIN","00168020230 CLINDAMYCIN ","30","Select","Select",""],["","49483060450","IBUPROFEN","49483060450 IBUPROFEN ","21","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","30","Select","Select",""],["","00603188016","LIDOCAINE","00603188016 LIDOCAINE ","30","Select","Select",""],["","71093014105","METHOCARBAM","71093014105 METHOCARBAM ","20","Select","Select",""],["","65649030302","XIFAXAN","65649030302 XIFAXAN ","60","Select","Select",""],["","00832105410","BACLOFEN","00832105410 BACLOFEN ","90","Select","Select",""],["","00093005805","TRAMADOL","00093005805 TRAMADOL ","8","Select","Select",""],["","45802041954","AMMONIUM","45802041954 AMMONIUM ","225","Select","Select",""],["","42806016005","HYDROXYZ","42806016005 HYDROXYZ ","90","Select","Select",""],["","70010049110","METFORMIN","TAB 500MG ER","60.00","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}