{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRANDY   M JUSTUS","gend":1,"add":"607 LINDEN PL","city":"SOUTH BOSTON","state":"VA","zip":"24592-9998","dob":"1988-09-27","age":"","mstatus":"","insh":"20030452*01","cliId":"","pno":"434\/272-2330","cno":"434\/272-2330","email":"","ename":"","eno":"","pphy":"LAHURD, NEIL J DO","ppno":"434\/835-4876","pcpadd":"949 PINEY FOREST ROAD","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":185602,"pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"434\/228-6766","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/835-4875","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F43.10","Z20.828","J01.90","K04.7","K11.21","F60.9","F45.21","F32.9","F60.3","J30.1","N89.8","R42.","L73.2","A63.0","D72.829","E61.1","J06.9","H69.81","N76.0","B99.9","G43.109","J30.9","L02.92","B00.9","J20.9","B96.89","F34.1","Z51.81","R53.82","R30.9","Z30.431","R30.0","R20.0","J01.00","R05.","F33.1","L02.211","D17.23","Z72.0","G06.2"],"date":["2021-10-20","2020-05-25","2021-09-23","2020-10-26","2020-11-18","2021-02-25","2021-09-20","2020-01-15","2020-06-04","2020-08-18","2020-06-23","2020-06-23","2020-09-08","2020-09-08","2021-06-29","2021-06-29","2020-02-20","2020-02-20","2020-10-08","2020-03-31","2020-07-02","2020-04-09","2020-04-09","2020-01-18","2020-05-23","2020-03-24","2021-09-20","2021-05-11","2021-06-17","2020-08-04","2020-10-08","2020-10-08","2020-07-02","2021-05-04","2021-05-04","2021-08-04","2020-06-08","2020-08-05","2020-12-12","2021-08-30"],"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":[["","69097084805","ESCITALOPRAM ","10MG","30","Select","Select",""],["","51991074790","DULOXETINE ","30MG","30","Select","Select",""],["","00002324030","CYMBALTA ","30MG","30","Select","Select",""],["","00574110404","BROM\/PSE\/DM ","","118","Select","Select",""],["","69452015120","VITAMIN ","50000UNT","3","Select","Select",""],["","68180046707","LOVASTATIN ","10MG","30","Select","Select",""],["","00591544305","PREDNISONE ","20MG","9","Select","Select",""],["","51672130200","TERCONAZOLE ","0.80%","20","Select","Select",""],["","59779048601","EAR ","6.50%","15","Select","Select",""],["","00093317431","ALBUTEROL ","HFA","8","Select","Select",""],["","00054327099","FLUTICASONE ","50MCG","16","Select","Select",""],["","45802091987","CETIRIZINE ","10MG","30","Select","Select",""],["","68180012202","CEPHALEXIN ","500MG","40","Select","Select",""],["","68180016013","AZITHROMYCIN ","250MG","6","Select","Select",""],["","65862042005","SMZ\/TMP ","800-160","14","Select","Select",""],["","63304069301","CLINDAMYCIN ","300MG","40","Select","Select",""],["","50111033401","METRONIDAZOL ","500MG","14","Select","Select",""],["","50428829925","FISH ","1000MG","30","Select","Select",""],["","70377002711","ATORVASTATIN ","10MG","30","Select","Select",""],["","59746000103","METHYLPRED ","4MG","21","Select","Select",""],["","68462053670","IMIQUIMOD ","5%","12","Select","Select",""],["","59267100002","PFIZER ","COVID-19","0","Select","Select",""],["","68382031818","MINOCYCLINE ","100MG","60","Select","Select",""],["","00234057508","HIBICLENS ","4%","236","Select","Select",""],["","60505016601","FLUVOXAMINE ","100MG","30","Select","Select",""],["","68180030260","CEFUROXIME ","250MG","14","Select","Select",""],["","59310057922","PROAIR ","","8","Select","Select",""],["","70710113908","FLUCONAZOLE ","150MG","3","Select","Select",""],["","59779045806","CVS ","10MG","30","Select","Select",""],["","68180059206","DESVENLAFAX ","50MG ER","30","Select","Select",""],["","13107008405","LORAZEPAM ","1MG","14","Select","Select",""],["","65862044990","VALACYCLOVIR ","1GM","30","Select","Select",""],["","69097084805","ESCITALOPRAM","10MG","3","Select","Select",""],["","00002324030","CYMBALTA","30MG","30","Select","Select",""],["","51991074790","DULOXETINE","30MG","30","Select","Select",""],["","00574110404","BROM\/PSE\/DM","","118","Select","Select",""],["","00054001825","PREDNISONE","20MG","9","Select","Select",""],["","68180046707","LOVASTATIN","10MG","30","Select","Select",""],["","51672130200","TERCONAZOLE","0.80%","20","Select","Select",""],["","69452015120","VITAMIN","50000UNT","3","Select","Select",""],["","00093317431","ALBUTEROL","HFA","8","Select","Select",""],["","45802091987","CETIRIZINE","10MG","30","Select","Select",""],["","00054327099","FLUTICASONE","50MCG","16","Select","Select",""],["","68180016013","AZITHROMYCIN","250MG","6","Select","Select",""],["","65862042005","SMZ\/TMP","800-160","14","Select","Select",""],["","68180012202","CEPHALEXIN","500MG","40","Select","Select",""],["","50428829925","FISH","1000MG","30","Select","Select",""],["","59746000103","METHYLPRED","4MG","21","Select","Select",""],["","59779048601","EAR","6.50%","15","Select","Select",""],["","68682045570","METRONIDAZOL","0.75%VAG","70","Select","Select",""],["","68382031818","MINOCYCLINE","100MG","60","Select","Select",""],["","59762374401","CLINDAMYCIN","10MG\/ML","60","Select","Select",""],["","68462053670","IMIQUIMOD","5%","12","Select","Select",""],["","00234057508","HIBICLENS","4%","236","Select","Select",""],["","60505016601","FLUVOXAMINE","100MG","30","Select","Select",""],["","68180030260","CEFUROXIME","250MG","14","Select","Select",""],["","70377002711","ATORVASTATIN","10MG","30","Select","Select",""],["","59779045806","CVS","10MG","30","Select","Select",""],["","70710113908","FLUCONAZOLE","150MG","3","Select","Select",""],["","68180059206","DESVENLAFAX","50MG ER","30","Select","Select",""],["","59267100002","PFIZER","COVID-19","0","Select","Select",""],["","65862017760","CEFDINIR","300MG","20","Select","Select",""],["","13107008405","LORAZEPAM","1MG","14","Select","Select",""],["","65862044990","VALACYCLOVIR","1GM","30","Select","Select",""],["","59310057922","PROAIR","","8","Select","Select",""],["","65862017760","CEFDINIR ","CAP 300MG","20","Select","Select",""],["","11917018320","BUDESONIDE ","SUS 32MCG","8","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","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","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":""}]}]}