{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHINETTA JONES","gend":1,"add":"335 AUDUBON DRIVE","city":"DANVILLE","state":"VA","zip":"24540-4261","dob":"1950-06-01","age":"","mstatus":"","insh":10052132,"cliId":"","pno":4342280592,"cno":4342280592,"email":"","ename":"","eno":"","pphy":"SETTLE, PAUL C","ppno":4347912273,"pcpadd":"404 Airport Dr, Ste A","pcpcity":"Danville","pcpstate":"VA","pcpzip":245405196,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"APT 28B","add3":"","madd1":"121 Carefree Ln Lot 23","madd2":"APT 28B","madd3":"","mcity":"Ringgold","mstate":"VA","mzip":"24586-4103","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","E55.9","E11.9","H25.13","H52.4","R68.89","J18.9","R50.9","R51","M79.10","Z20.828","E78.00","J45.909","Z88.0","Z91.013","Z88.2","R74.0","M65.4","A41.9","Z09","M79.621","R59.0","M54.5","M51.36","M77.8","E66.3","Z11.59","D86.9","M06.9","E78.5","Z85.038","Z90.710","Z79.82","Z79.899","R05","R07.89","R10.84","R06.02","R52","R93.6","M79.645","Z23","I20.8","R00.1","R94.31","R11.2","R22.31","M67.834","Z12.31","M25.532","J40","J20.9","J45.901","E11.65","D64.9","E83.39","E44.1","E66.01","Z68.41","R74.8","I31.3","I44.7","R93.89","B37.0","G56.02","J15.8","Z03.818","J18.8","M79.603","M79.2","R20.2"],"date":["2021-03-19","2020-04-10","2021-03-19","2020-08-17","2020-08-17","2020-07-15","2020-07-15","2020-07-10","2020-07-10","2020-07-10","2020-07-15","2021-02-26","2021-03-12","2020-07-10","2020-09-02","2020-09-02","2020-09-01","2021-03-19","2020-03-04","2020-07-15","2020-07-28","2020-08-10","2020-09-04","2020-12-09","2021-01-28","2020-09-04","2021-03-12","2021-03-12","2021-03-12","2021-03-12","2021-03-12","2021-03-12","2021-03-12","2021-03-12","2020-03-03","2020-03-03","2020-03-03","2020-03-03","2020-03-20","2020-07-23","2020-09-02","2020-11-23","2019-12-23","2019-12-23","2020-12-28","2020-07-21","2020-09-14","2020-10-22","2020-06-30","2020-09-23","2020-03-03","2020-03-03","2020-03-03","2020-03-03","2020-03-03","2020-03-03","2020-03-03","2020-03-03","2020-03-03","2020-03-03","2020-03-03","2020-12-28","2020-03-10","2020-03-10","2021-01-07","2020-03-03","2020-07-10","2020-07-10","2021-03-30","2021-03-30","2021-03-30"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"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":[]}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","62037083001","METOPROL ","TAB 25MG ER","30","Select","Select",""],["","66993058697","FLUTIC\/SALME ","AER 500\/50","60","Select","Select",""],["","76385012810","METFORMIN ","TAB 500MG ER","30","Select","Select",""],["","00378932232","WIXELA ","AER 500\/50","60","Select","Select",""],["","40985027139","VITAMIN ","TAB 1000UNIT","30","Select","Select",""],["","68180037803","LOSARTAN ","TAB 100MG","30","Select","Select",""],["","69097012815","AMLODIPINE ","TAB 10MG","90","Select","Select",""],["","55111028130","LEVOFLOXACIN ","TAB 750MG","5","Select","Select",""],["","66689000816","NYSTATIN ","SUS 100000","224","Select","Select",""],["","00054429931","FUROSEMIDE ","TAB 40MG","30","Select","Select",""],["","00173069700","ADVAIR ","AER 500\/50","60","Select","Select",""],["","59310057922","PROAIR ","AER ","8.5","Select","Select",""],["","51224000160","BENZONATATE ","CAP 200MG","15","Select","Select",""],["","59746017306","PREDNISONE ","TAB 10MG","21","Select","Select",""],["","69097096507","NABUMETONE ","TAB 500MG","60","Select","Select",""],["","61442010260","DICLOFENAC ","TAB 50MG DR","60","Select","Select",""],["","56151014201","TRUEDRAW ","MIS LANC DEV","1","Select","Select",""],["","50111078855","AZITHROMYCIN ","TAB 500MG","4","Select","Select",""],["","65862017760","CEFDINIR ","CAP 300MG","8","Select","Select",""],["","79854009074","TURMERIC ","MG CAPSULE","60","Select","Select",""],["","00143211205","DOXYCYCL ","TAB 100MG","20","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}