{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TONYA   M PHILLIPS","gend":1,"add":"1222 ALMO CHAPEL ROAD","city":"STEELES TAVERN","state":"VA","zip":"24476-2011","dob":"1981-08-21","age":"","mstatus":"","insh":6874355,"cliId":"","pno":5404141814,"cno":5402921527,"email":"","ename":"","eno":"","pphy":"MARSH, JOHN","ppno":5409817000,"pcpadd":"36 CHERRY GROVE ROAD, ","pcpcity":"MIDDLEBROOK","pcpstate":"VA","pcpzip":244590000,"pcpcounty":"","pcpid":"","pcpname":"MIDDLEBROOK FAMILY MEDICINE PLC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"1222 ALMO CHAPEL ROAD","madd2":"","madd3":"","mcity":"STEELES TAVERN","mstate":"VA","mzip":"24476-2011","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M77.11","G56.01","G37.9","M79.641","F32.3","F41.9","R41.82","E66.01","F32.9","J06.9","J04.0","M25.521","M67.823","S53.431A","G37.3","G43.109","M77.12","R53.83","R63.5","Z79.899","R07.9","S29.011A","R11.2","R42","R82.90","H69.81","H81.13","Z79.890","H31.091","H35.351","R30.9","K59.09","R05","R09.81","J02.9","Z20.822","R00.2","R51.9","Z01.810","M62.830","R00.0","R53.82","K21.9","R06.00","R06.09","R19.7","U07.1","Z23","E66.9","M25.511","Z11.1","Z01.419","N89.8","R22.1","J20.9","R19.4","M54.6","M47.14","G89.29","R51","Z68.39","M54.5","F33.9","H69.92","M51.36","M51.34","Z86.69","M54.9","M47.814","G89.4","M79.10","M25.78","M79.601","G95.89","W19.XXXA","M25.512","R07.89","F32.1","Z72.0","F43.10","R20.2","M54.32","M72.2","L91.8","L98.9","L57.0","M77.9","F33.2","D23.61","D23.72","L81.4","M47.9","M40.204","M40.56","M48.02","M48.05","Z01.812","R26.89","M48.061","M50.222","M51.84","D18.09","Z79.891","E04.1","N28.1","B37.3","E86.0","N60.11","G83.21","R53.81","Z87.42","N64.89","N63.10","N63.20","N64.4","R92.8","D24.1","G56.11","N63.11","N60.81","Z90.710"],"date":["2020-05-11","2020-03-06","2020-01-07","2020-01-07","2021-03-31","2020-01-13","2020-01-13","2020-04-16","2022-01-24","2020-02-23","2020-02-23","2020-02-28","2020-02-28","2020-02-28","2022-01-24","2020-07-28","2020-07-28","2021-10-08","2021-01-05","2020-08-28","2021-10-07","2020-12-09","2020-12-29","2021-10-07","2020-12-31","2020-12-31","2021-01-05","2021-01-05","2021-06-21","2021-06-21","2021-06-23","2021-06-23","2021-07-02","2021-07-02","2021-12-13","2021-12-13","2022-01-24","2021-12-13","2021-10-07","2021-10-07","2021-10-07","2022-01-24","2022-01-24","2022-01-12","2021-11-08","2021-12-13","2021-12-16","2021-12-16","2022-01-24","2022-01-27","2022-02-11","2022-03-07","2022-03-07","2022-04-05","2019-01-03","2019-01-15","2019-01-31","2019-01-17","2019-10-24","2019-01-17","2019-01-17","2019-04-30","2019-01-17","2019-01-31","2019-08-28","2019-08-28","2019-01-23","2019-01-23","2019-01-23","2019-03-21","2019-03-21","2019-02-09","2019-06-06","2019-04-30","2019-04-30","2019-05-13","2019-05-13","2019-06-05","2019-06-05","2019-06-05","2019-06-06","2019-06-06","2019-06-06","2019-06-25","2019-06-25","2019-06-25","2019-10-24","2019-10-24","2019-08-13","2019-08-13","2019-08-13","2019-08-14","2019-08-28","2019-08-28","2019-09-20","2019-09-20","2019-09-20","2019-08-28","2019-09-20","2019-09-20","2019-09-20","2019-09-20","2019-09-23","2019-10-24","2019-10-24","2019-10-24","2019-10-24","2019-12-06","2019-11-27","2019-11-27","2019-11-27","2019-12-02","2019-12-02","2019-12-02","2019-12-02","2019-12-02","2019-12-06","2019-12-06","2019-12-06","2019-12-06","2019-12-06"],"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":[["","69452015120","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","51267089099","CONTRAVE","TAB 8-90MG","120","Select","Select",""],["","42806008801","ESTRADIOL","TAB 1MG","30","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","59267102501","PFIZER","INJ ADLT RTU","0.30","Select","Select",""],["","42806034909","BUPROPN","TAB 300MG XL","30","Select","Select",""],["","16729017301","AMITRIPTYLIN","TAB 50MG","30","Select","Select",""],["","00527133001","BACLOFEN","TAB 10MG","60","Select","Select",""],["","67877057501","BENZONATATE","CAP 200MG","30","Select","Select",""],["","13668001890","VENLAFAXINE","CAP 37.5 ER","30","Select","Select",""],["","29300022701","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","65862019399","FLUOXETINE","CAP 20MG","90","Select","Select",""],["","43547038103","DULOXETINE","CAP 60MG","60","Select","Select",""],["","13668021790","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","30","Select","Select",""],["","00527131001","PHENTERMINE","CAP 30MG","30","Select","Select",""],["","13668001101","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","76385012401","METHOCARBAM","TAB 750MG","40","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","65162044210","MECLIZINE","TAB 25MG","15","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","60505025202","TIZANIDINE","TAB 4MG","30","Select","Select",""],["","00054001725","PREDNISONE","TAB 10MG","12","Select","Select",""],["","00456120130","LINZESS","CAP 145MCG","30","Select","Select",""],["","68462012801","ZONISAMIDE","CAP 25MG","60","Select","Select",""],["","68462024805","RANITIDINE","TAB 150MG","60","Select","Select",""],["","62756052169","SUMATRIPTAN","TAB 50MG","9","Select","Select",""],["","50383077916","LACTULOSE","SOL 10GM\/15","300","Select","Select",""],["","65862001205","SERTRALINE","TAB 50MG","30","Select","Select",""],["","67253090050","ALPRAZOLAM","TAB 0.25MG","20","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","67877021560","CEFUROXIME","TAB 250MG","20","Select","Select",""],["","59762444002","METHYLPRED","TAB 4MG","21","Select","Select",""],["","50383080416","PROMETH\/COD","SYP 6.25-10","120","Select","Select",""],["","49281041950","FLUZONE","INJ 2019-20","0.5","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","53746010905","HYDROCO\/APAP","TAB 5-325MG","40","Select","Select",""],["","67405060301","FLUCONAZOLE","TAB 150MG","2","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":""}]}]}