{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JACLYNN MCGUIRE","gend":1,"add":"105 WOODLAWN DRIVE                                          ","city":"ROCKY MOUNT                   ","state":"VA","zip":"24151-1139","dob":"1992-10-14","age":"","mstatus":"","insh":10195545,"cliId":"","pno":5405105424,"cno":5404834436,"email":"","ename":"","eno":"","pphy":"MAXEY, JAMES                                                ","ppno":"","pcpadd":"195 Maple Ave","pcpcity":"Rocky Mount                   ","pcpstate":"VA","pcpzip":241511506,"pcpcounty":"","pcpid":"P0117414","pcpname":"CARILION FAMILY MEDICINE ROCKY MOUNT","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"105 WOODLAWN DRIVE                                          ","madd2":"                                                            ","madd3":"","mcity":"ROCKY MOUNT                   ","mstate":"VA","mzip":"24151-1139","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z36.87","Z3A.15","Z36.89","O23.41","O23.42","Z3A.20","Z23","Z34.02","O99.212","Z3A.24","Z36.2","Z3A.28","O99.810","O24.419","O24.414","Z3A.33","O99.213","O09.93","O28.8","Z03.79","O36.8130","Z3A.34","Z3A.35","Z3A.36","O24.913","Z79.4","Z3A.37","O32.1XX0","E66.9","Z3A.38","Z20.2","O24.424","O13.4","D64.9","Z37.0","O32.0XX0","O62.1","O77.0","O99.02","O99.214","O99.52","J45.909","Z87.891","O32.2XX0","O62.0","O61.0","Z3A.39","O66.40","K80.10","K80.12","K80.00","E66.01","Z68.41","K80.20","R19.8","K83.8","K81.0","K80.11","K82.4","K81.9","R00.1","R07.9","R10.11","N92.6","Z32.02","Z11.3","M25.562","X50.1XXA","Y93.9","Y92.9","S83.242A","Z01.812","Z01.818","S83.512A","G89.18","S83.212A","Z68.43","J45.20","F17.210","Z47.89","Z48.89","Z98.890","R26.2","M25.662","N30.00","N93.9","R10.2","R30.0","N89.8","Z79.899","M17.12"],"date":["2019-08-06","2019-08-06","2019-09-09","2019-09-09","2019-09-09","2019-09-09","2021-01-29","2019-11-04","2019-10-07","2019-10-07","2019-11-07","2019-11-07","2019-11-11","2020-01-14","2020-01-16","2019-12-12","2020-01-14","2019-12-26","2019-12-12","2019-12-11","2019-12-12","2019-12-17","2019-12-23","2019-12-30","2020-01-03","2020-01-03","2020-01-07","2020-01-06","2021-02-09","2020-01-14","2020-01-17","2020-01-21","2020-01-20","2020-01-20","2020-01-21","2020-01-20","2020-01-20","2020-01-20","2020-01-20","2020-01-20","2020-01-20","2021-09-09","2020-10-25","2020-01-20","2020-01-21","2020-01-21","2020-01-21","2020-01-21","2020-04-16","2020-04-16","2020-04-16","2020-11-03","2020-04-16","2020-04-16","2020-04-16","2020-04-16","2020-04-16","2020-04-16","2020-04-16","2020-04-16","2020-04-16","2020-04-16","2020-04-16","2020-08-04","2020-08-04","2020-08-04","2021-04-02","2020-10-25","2020-10-25","2020-10-25","2021-02-09","2021-01-29","2021-02-04","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-09-09","2021-02-16","2021-05-14","2021-05-14","2021-04-02","2021-04-02","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2020-10-30"],"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":[["","68180016113","AZITHROMYCIN","500MG","2","Select","Select",""],["","00193731221","CONTOUR","NEXT","100","Select","Select",""],["","68180012202","CEPHALEXIN","500MG","21","Select","Select",""],["","45802048678","DOCUSATE","100MG","30","Select","Select",""],["","00536100901","FERROUS","325MG","60","Select","Select",""],["","65162036111","FOLIC","1MG","30","Select","Select",""],["","67877032005","IBUPROFEN","600MG","30","Select","Select",""],["","59779076678","PAIN","325MG","60","Select","Select",""],["","57664022388","OXYCODONE","5MG","20","Select","Select",""],["","51862088403","CAMILA","0.35MG","28","Select","Select",""],["","53746010901","HYDROCO\/APAP","5-325MG","10","Select","Select",""],["","65162019050","NAPROXEN","500MG","60","Select","Select",""],["","68180016113","AZITHROMYCIN ","TAB 500MG","2","Select","Select",""],["","00193731221","CONTOUR ","TES NEXT","100","Select","Select",""],["","68180012202","CEPHALEXIN ","CAP 500MG","21","Select","Select",""],["","45802048678","DOCUSATE ","CAP 100MG","30","Select","Select",""],["","00536100901","FERROUS ","TAB 325MG","60","Select","Select",""],["","65162036111","FOLIC ","TAB 1MG","30","Select","Select",""],["","67877032005","IBUPROFEN ","TAB 600MG","30","Select","Select",""],["","59779076678","PAIN ","TAB 325MG","60","Select","Select",""],["","57664022388","OXYCODONE ","TAB 5MG","20","Select","Select",""],["","51862088403","CAMILA ","TAB 0.35MG","28","Select","Select",""],["","53746010901","HYDROCO\/APAP ","TAB 5-325MG","10","Select","Select",""],["","65162019050","NAPROXEN ","TAB 500MG","60","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":""}]}]}