{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MICHELLE   M FEUILLATRE","gend":1,"add":"720   BLUE RIDGE AVENUE                                     ","city":"BEDFORD                       ","state":"VA","zip":"24523-2533","dob":"1984-01-20","age":"","mstatus":"","insh":4758384,"cliId":"","pno":5403090805,"cno":"","email":"","ename":"","eno":"","pphy":"COX, BRANDON K                                              ","ppno":5402977181,"pcpadd":"1613 Oakwood St                                             ,Ste 101                                                     ","pcpcity":"Bedford                       ","pcpstate":"VA","pcpzip":245231213,"pcpcounty":"","pcpid":"","pcpname":"VILLAGE FAMILY PHYSICIANS INC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"720   BLUE RIDGE AVENUE                                     ","add3":"","madd1":"720   BLUE RIDGE AVENUE                                     ","madd2":"APT F52                                                     ","madd3":"","mcity":"BEDFORD                       ","mstate":"VA","mzip":"24523-2533","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z01.00","H52.11","H52.223","H33.321","F41.1","I10","F17.200","Z30.09","Z01.411","F41.9","K52.9","F43.10","F41.0","F41.8","F33.0","S62.624A","F17.210","W22.09XA","M79.641","S63.254A","F33.1","F51.01","M79.644","Z53.8","Z11.59","W23.1XXA","Z11.3","A59.01","R76.8","Z02.71","M25.472","M79.89","Z72.0","R60.1","Z86.19","Z20.828","Z12.31","J02.9","J40","R06.02","R03.0","K21.9","N63.0","R92.8","Z80.3","Z80.1","H04.123","R05","R09.81","R07.89","Z77.120","Z20.822","R07.9","R09.89","E03.9","R49.0","J44.9","H65.92","H93.8X2","R11.0","E87.6","R79.89","R74.8","E06.3","F10.20","Z71.6","N92.6","Z23","R68.84","Z20.2","K08.9","Z71.3","Z71.82","K04.7","B37.9","T36.95XA","R40.20","F10.239","R55","F10.929","F10.10","N39.0","F19.10","S09.90XA","S19.9XXA","R56.9","R31.9","F14.90","N30.00","R10.9","M54.2","F43.21","K08.89","Z32.02"],"date":["2021-07-19","2021-07-19","2021-07-19","2020-02-14","2020-06-11","2022-11-08","2022-11-08","2020-06-11","2020-06-23","2022-02-21","2020-06-23","2021-10-22","2021-10-22","2020-08-14","2021-10-22","2020-09-01","2021-07-22","2020-07-31","2020-07-31","2020-07-31","2021-10-22","2021-10-22","2020-08-03","2020-08-05","2020-08-05","2020-08-14","2021-11-23","2020-10-02","2020-10-02","2020-10-14","2020-11-09","2022-11-08","2020-11-09","2020-11-09","2021-01-19","2021-02-26","2021-06-08","2021-06-25","2021-07-22","2021-08-09","2021-07-07","2021-07-07","2021-07-16","2021-07-16","2021-07-16","2021-07-16","2021-07-19","2021-08-12","2021-07-27","2021-07-27","2021-07-27","2021-07-27","2022-11-08","2021-07-27","2021-07-27","2021-08-12","2021-09-13","2021-08-12","2021-08-12","2021-08-12","2022-02-02","2021-08-27","2021-10-22","2021-10-22","2022-02-21","2021-09-13","2022-11-27","2021-12-20","2021-12-30","2021-11-23","2021-12-20","2021-11-23","2021-11-23","2022-11-27","2021-12-30","2021-12-30","2022-02-01","2022-02-01","2022-02-02","2022-02-02","2022-02-02","2022-02-02","2022-02-02","2022-02-02","2022-02-02","2022-11-08","2022-02-21","2022-02-21","2022-09-14","2022-09-14","2022-11-08","2022-12-08","2022-11-27","2022-11-27"],"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":[["","16729027810","ARIPIPRAZOLE","TAB 2MG","30","Select","Select",""],["","00074434190","SYNTHROID","TAB 25MCG","30","Select","Select",""],["","00591555501","PROPRANOLOL","TAB 20MG","60","Select","Select",""],["","40093014002","D3","CAP 50MCG","30","Select","Select",""],["","49100040009","CULTURELLE","CAP ","30","Select","Select",""],["","00781148701","AMITRIPTYLIN","TAB 25MG","30","Select","Select",""],["","62332004890","LOSARTAN\/HCT","TAB 50-12.5","30","Select","Select",""],["","10006070022","VITAMIN","TAB 1000MCG","30","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","14","Select","Select",""],["","16714069211","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","21","Select","Select",""],["","68462030329","HEATHER","TAB 0.35MG","84","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","16729013600","CLONAZEPAM","TAB 0.5MG","30","Select","Select",""],["","57896050110","ONE-DAILY","TAB MULT-VIT","30","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","14","Select","Select",""],["","65862001705","AMOXICILLIN","CAP 500MG","14","Select","Select",""],["","68180085211","MY","TAB 1.5MG","1","Select","Select",""],["","00406117003","NALTREXONE","TAB 50MG","30","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10.2","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","65862042001","SMZ\/TMP","TAB 800-160","10","Select","Select",""],["","31722070110","LOSARTAN","TAB 50MG","30","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","37000014343","ALIGN","CAP 4MG","28","Select","Select",""],["","00536137206","NICOTINE","GUM 4MG MINT","100","Select","Select",""],["","00054981729","PREDNISONE","TAB 10MG","60","Select","Select",""],["","49348085316","SM","LOZ 4MG MINT","72","Select","Select",""],["","57237007730","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","00536124207","ANTIHISTAMIN","TAB 60-120MG","20","Select","Select",""],["","16714023501","PENICILLN","TAB 500MG","28","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0.3","Select","Select",""],["","57237000830","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","00456112030","VIIBRYD","TAB 20MG","30","Select","Select",""],["","68180035109","SERTRALINE","TAB 25MG","30","Select","Select",""],["","50111043302","TRAZODONE","TAB 50MG","30","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","30","Select","Select",""],["","63304061650","DOXYCYC","CAP 100MG","14","Select","Select",""],["","14539067401","HYDROXYZ","CAP 25MG","56","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":""}]}]}