{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KRISTINE   N WARNER","gend":1,"add":"1920 TABBY LN","city":"ALTAVISTA","state":"VA","zip":"24517-9998","dob":"2002-12-20","age":"","mstatus":"","insh":"1030028*01","cliId":"","pno":"434\/906-9386","cno":"","email":"","ename":"","eno":"","pphy":"MADDY, ALLISON NP","ppno":"434\/656-1274","pcpadd":"291 MCBRIDE LANE","pcpcity":"GRETNA","pcpstate":"VA","pcpzip":24557,"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\/656-3405","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.1","F41.0","K64.0","K59.09","Z71.9","U07.1","R00.0","F41.9","R07.89","F45.21","R00.2","R07.9","R20.2","B07.8","Z78.9","R10.84","R11.11","R19.7","R52.","R06.89","Z30.09","NO DATA","Z01.419","R20.0","R51.9","F32.1","Z23.","F41.8","R06.02","R05.9","N89.8","R10.2","B34.9","R55.","K92.1","K59.00","J32.9","Z04.89","L03.90","R94.31","R09.81","J02.9","R10.13","I47.1","M67.431","M35.7","M25.531","N94.6","Z30.41","M67.439","J30.89"],"date":["2022-11-22","2022-09-02","2022-03-01","2022-03-01","2022-03-01","2022-06-07","2022-08-12","2022-10-17","2022-08-29","2022-10-25","2022-08-29","2022-08-29","2022-08-12","2022-05-03","2022-05-03","2022-07-20","2022-07-20","2022-07-20","2022-07-20","2022-08-12","2021-10-18","2022-10-17","2021-10-18","2021-11-21","2022-08-24","2022-08-12","2021-12-15","2022-02-08","2022-06-01","2022-06-07","2022-07-05","2022-07-05","2022-07-20","2022-08-29","2022-02-15","2022-08-12","2022-03-27","2022-08-24","2022-05-26","2022-08-29","2022-05-31","2022-05-31","2022-07-20","2022-08-12","2022-05-27","2022-05-27","2022-05-27","2021-12-29","2021-12-29","2022-03-16","2022-10-17"],"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":[]},{"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":[["","16729020001","BUSPIRONE","TAB 5MG","60","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","00555902658","JUNEL","TAB 43831","28","Select","Select",""],["","45802048678","DOCUSATE","CAP 100MG","60","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","30","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","00121092716","PROMETHAZINE","SOL 6.25\/5ML","200","Select","Select",""],["","62756052069","SUMATRIPTAN","TAB 25MG","9","Select","Select",""],["","00093342210","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","42806016005","HYDROXYZ","TAB 25MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","10","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","90","Select","Select",""],["","68462073129","HAILEY","TAB FE","28","Select","Select",""],["","50111064701","FLUOXETINE","CAP 10MG","30","Select","Select",""],["","78206014501","NEXPLANON","IMP 68MG","1","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":""}]}]}