{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHRISTOPHER   L LOWE","gend":0,"add":"1620   HAILFAX ROAD                                         ","city":"DANVILLE                      ","state":"VA","zip":"24540-4848","dob":"1993-07-07","age":"","mstatus":"","insh":10121040,"cliId":"","pno":4342512679,"cno":4342512679,"email":"","ename":"","eno":"","pphy":"KURIAN, WILBY                                               ","ppno":"","pcpadd":"404 Airport Dr Ste A","pcpcity":"Danville                      ","pcpstate":"VA","pcpzip":245405196,"pcpcounty":"","pcpid":"P9338917","pcpname":"CENTRA MEDICAL GROUP","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"LOT 17                                                      ","add3":"","madd1":"1224 Halifax Rd                                             ","madd2":"Lot A                                                       ","madd3":"","mcity":"DANVILLE                      ","mstate":"VA","mzip":"24540-4848","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R42","R53.83","G47.00","F32.0","F41.9","R07.9","R07.89","I07.1","K21.9","R10.9","M94.0","R05","R09.1","Z87.891","Z91.018","R07.1","Z79.899","E55.9","J30.9","F17.210","R06.02","K92.2","Z88.8","Z72.0","F41.0","K85.90","R10.11","R06.00","Z91.011","R00.2","R06.4","R20.0","R07.2","N20.2","R10.30","M54.5","Z51.81","N20.1","M54.9","R52","I10","R61","R21","L29.9","E73.9","J09.X2","R50.9","J34.89","L50.0","R06.03","K02.9","K08.89","Z91.048","R68.84","R11.2","Z91.040","Z53.20","N20.0","Z90.49","R30.0","A74.89","Z20.2","E86.0","J32.9","J02.9","M79.10","Z20.822"],"date":["2021-07-14","2019-01-08","2019-01-08","2021-09-02","2021-09-02","2021-09-11","2021-09-11","2019-01-31","2019-04-17","2020-11-12","2019-02-17","2019-04-17","2019-02-17","2019-06-20","2019-02-17","2019-02-17","2019-04-16","2020-06-23","2021-04-05","2021-07-14","2021-07-14","2019-04-17","2020-03-26","2021-06-29","2019-06-20","2019-05-12","2019-05-12","2021-09-11","2021-07-14","2019-06-10","2019-07-04","2019-07-04","2019-07-30","2019-07-31","2019-07-31","2019-07-31","2021-03-23","2019-10-28","2019-10-28","2019-10-28","2020-12-27","2019-10-28","2020-02-22","2020-01-17","2020-02-22","2020-01-22","2021-10-06","2020-01-22","2020-02-22","2020-03-26","2020-10-10","2020-10-10","2020-10-10","2020-10-10","2021-10-06","2020-11-12","2020-12-21","2021-04-05","2021-04-05","2021-06-29","2021-06-29","2021-06-29","2021-09-11","2021-10-06","2021-10-06","2021-10-06","2021-10-06"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",null]}},{"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":[["","00093083205","CLONAZEPAM","0.5MG","30","Select","Select",""],["","63304069205","CLINDAMYCIN","150MG","28","Select","Select",""],["","49483060450","IBUPROFEN","800MG","16","Select","Select",""],["","16729020001","BUSPIRONE","5MG","90","Select","Select",""],["","00093310905","AMOXICILLIN","500MG","21","Select","Select",""],["","71930005552","APAP\/CODEINE","300-30MG","16","Select","Select",""],["","00093005805","TRAMADOL","50MG","12","Select","Select",""],["","59779076678","PAIN","325MG","30","Select","Select",""],["","65862050320","AMOX\/K","875-125","20","Select","Select",""],["","53746010901","HYDROCO\/APAP","5-325MG","10","Select","Select",""],["","65862085901","FAMOTIDINE","20MG","10","Select","Select",""],["","12547017021","BENADRYL","25MG","24","Select","Select",""],["","00378064110","PREDNISONE","10MG","35","Select","Select",""],["","00054327099","FLUTICASONE","50MCG","16","Select","Select",""],["","45802065078","LORATADINE","10MG","30","Select","Select",""],["","00115165903","PROPRANOLOL","10MG","60","Select","Select",""],["","24658031205","DOXYCYCL","100MG","14","Select","Select",""],["","69097083305","SERTRALINE","25MG","30","Select","Select",""],["","49483060350","IBUPROFEN ","TAB 600MG","30","Select","Select",""],["","66993001968","ALBUTEROL ","AER HFA","18","Select","Select",""],["","65862039010","ONDANSETRON ","TAB 4MG ODT","12","Select","Select",""],["","00093083205","CLONAZEPAM ","TAB 0.5MG","30","Select","Select",""],["","63304069205","CLINDAMYCIN ","CAP 150MG","28","Select","Select",""],["","16729020001","BUSPIRONE ","TAB 5MG","90","Select","Select",""],["","00093310905","AMOXICILLIN ","CAP 500MG","21","Select","Select",""],["","71930005552","APAP\/CODEINE ","TAB 300-30MG","16","Select","Select",""],["","00093005805","TRAMADOL ","TAB 50MG","12","Select","Select",""],["","59779076678","PAIN ","TAB 325MG","30","Select","Select",""],["","65862050320","AMOX\/K ","TAB 875-125","20","Select","Select",""],["","53746010901","HYDROCO\/APAP ","TAB 5-325MG","10","Select","Select",""],["","65862085901","FAMOTIDINE ","TAB 20MG","10","Select","Select",""],["","12547017021","BENADRYL ","CAP 25MG","24","Select","Select",""],["","00378064110","PREDNISONE ","TAB 10MG","35","Select","Select",""],["","00054327099","FLUTICASONE ","SPR 50MCG","16","Select","Select",""],["","45802065078","LORATADINE ","TAB 10MG","30","Select","Select",""],["","00115165903","PROPRANOLOL ","TAB 10MG","60","Select","Select",""],["","24658031205","DOXYCYCL ","TAB 100MG","14","Select","Select",""],["","69097083305","SERTRALINE ","TAB 25MG","30","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":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","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":""}]}]}