{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHARONDA   D HOWARD","gend":1,"add":"2150 SINAI RD APT 12C","city":"SOUTH BOSTON","state":"VA","zip":"24592-9998","dob":"1977-10-15","age":"","mstatus":"","insh":"1006984*01","cliId":"","pno":"434\/288-6544","cno":"","email":"","ename":"","eno":"","pphy":"HILL, KELLY NP","ppno":"434\/835-4876","pcpadd":"3130 HALIFAX ROAD SUITE C","pcpcity":"SOUTH BOSTON","pcpstate":"VA","pcpzip":24592,"pcpcounty":"","pcpid":"","pcpname":"GODOCS SOUTH BOSTON LLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/835-4875","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R00.2","Z01.419","Z30.430","R07.89","R06.09","M54.2","R51.9","M62.838","Z20.828","F41.1","R26.89","G35.","F32.9","I10.","N30.01","K21.9","J30.2","H92.03","F45.8","K13.21","B37.3","Z23.","H66.91","M25.562","M79.89","Z91.02","K11.8","F33.1","J32.2","J30.89","M79.2","R07.0","J02.8","M26.609","R68.84","R60.9","R51.","J01.90","R09.82"],"date":["2020-01-27","2021-01-06","2021-01-06","2020-01-27","2020-01-27","2021-02-12","2021-02-12","2021-02-12","2021-01-26","2021-07-08","2021-07-08","2021-11-09","2021-07-08","2020-01-16","2021-06-11","2020-12-17","2020-05-28","2020-10-28","2020-10-28","2020-10-28","2021-07-09","2021-07-30","2021-08-14","2021-11-09","2021-11-09","2021-11-09","2020-10-20","2020-01-31","2020-12-17","2020-12-17","2021-02-15","2019-06-07","2019-06-07","2019-08-01","2019-08-01","2019-08-01","2019-07-19","2019-01-29","2019-01-29"],"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":[["","69097096607","NABUMETONE","TAB 750MG","10","Select","Select",""],["","64406002003","VUMERITY","CAP 231MG","120","Select","Select",""],["","68180030360","CEFUROXIME","TAB 500MG","14","Select","Select",""],["","","TECFIDERA"," TECFIDERA ","60","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","51672130406","TERCONAZOLE","CRE 0.004","45","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","28","Select","Select",""],["","71093014105","METHOCARBAM","TAB 750MG","10","Select","Select",""],["","","MONTELUKAST","TAB 10MG","","Select","Select",""],["","69097083512","SERTRALINE","TAB 100MG","60","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","20","Select","Select",""],["","","AZITHROMYCIN"," AZITHROMYCIN ","6","Select","Select",""],["","","BUPROPION"," BUPROPION ","30","Select","Select",""],["","","GABAPENTIN"," GABAPENTIN ","30","Select","Select",""],["","","MELOXICAM"," MELOXICAM ","30","Select","Select",""],["","","XULANE"," XULANE ","3","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","10","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","","FLORASTOR","CAP 250MG","","Select","Select",""],["","","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","","LORATADINE","TAB 10MG","","Select","Select",""],["","","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","","CEFDINIR","CAP 300MG","","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","","ORPHENADRINE","TAB 100MG CR","","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":""}]}]}