{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MEAGAN   R THACKER","gend":1,"add":"180 COVINGTON DR","city":"HURT","state":"VA","zip":"24563-9998","dob":"1998-01-09","age":"","mstatus":"","insh":"1017362*01","cliId":"","pno":"434-728-4052","cno":"434\/209-7058","email":"","ename":"","eno":"","pphy":"ADAMS, DAVID MD","ppno":"434\/857-3600","pcpadd":"414 PARK AVE","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"CENTRA MEDICAL GROUP LLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/857-3601","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25.371","NO DATA","N28.9","J45.909","F32.0","U07.1","G89.29","R52.","N83.201","F17.210","Z79.899","Z30.432","F41.8","L70.0","L81.0","L85.3","K13.0","R04.0","H02.89","H00.11","H00.14","M54.5","M54.2","R10.84","N76.0","B96.89","F32.9","N83.209","R11.0","R19.7","F41.0","R07.81","M25.571","G43.109","G40.909","Z87.891","R51.9","L20.84","R68.89"],"date":["2019-10-25","2021-12-03","2021-12-03","2021-12-03","2021-12-03","2021-12-03","2019-08-18","2019-08-18","2020-04-15","2020-04-15","2021-04-22","2021-01-18","2021-05-27","2021-04-22","2021-04-22","2021-04-22","2021-04-22","2021-04-22","2019-01-11","2021-04-08","2019-11-22","2019-11-27","2019-11-27","2019-11-27","2020-02-14","2020-02-14","2020-02-14","2020-04-27","2021-11-26","2021-11-26","2021-05-27","2020-03-21","2019-01-11","2019-02-20","2019-02-20","2019-02-20","2021-03-11","2021-03-11","2021-11-07"],"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":[["","","IBUPROFEN"," IBUPROFEN ","30","Select","Select",""],["","","NEXPLANON"," NEXPLANON ","1","Select","Select",""],["","","NEO\/POLY\/DEX"," NEO\/POLY\/DEX ","4","Select","Select",""],["","","METOCLOPRAM"," METOCLOPRAM ","28","Select","Select",""],["","","PREDNISOLONE"," PREDNISOLONE ","5","Select","Select",""],["","","NAPROXEN"," NAPROXEN ","28","Select","Select",""],["","","CLINDAMYCIN","GEL 0.01","","Select","Select",""],["","","TRETINOIN","CRE 0.00025","","Select","Select",""],["","","SOD","EMU 10-5%","","Select","Select",""],["","","DOXYCYC","CAP 100MG","","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","","AZITHROMYCIN","TAB 500MG","","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":""}]}]}