{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRITTANY DAVIS","gend":1,"add":"509 N DELPHINE AVE","city":"WAYNESBORO","state":"VA","zip":"22980-9998","dob":"1990-06-07","age":"","mstatus":"","insh":"1249909*01","cliId":"","pno":"540\/649-6251","cno":"","email":"","ename":"","eno":"","pphy":"TRAN, GEORGE MD","ppno":"540\/245-7806","pcpadd":"3881 CHURCHVILLE AVE","pcpcity":"CHURCHVILLE","pcpstate":"VA","pcpzip":24421,"pcpcounty":"","pcpid":"","pcpname":"AUGUSTA MEDICAL GROUP","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/213-9264","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K44.9","K21.0","R13.10","F41.9","F34.1","N64.3","K52.9","K92.1","Z87.19","R10.30","R42.","N93.8","H53.8","F31.9","R58.","R10.9","R10.2","Z98.51","R87.612","L29.9","R06.00","Z01.810","I49.3","I49.1","R06.09","N92.0","G89.29","R63.4","F32.9","R19.7","R31.21","S49.91XA","R07.9","Z20.828","NO DATA","F17.200","R51.9","Z01.419","K58.0","F17.210","R63.8","M54.9","R00.0","R94.31","R07.89","R10.11","K21.9","R73.9","R11.0","R14.0","K59.1","K64.9","K29.70","G43.109","J06.9","Z72.0","S16.1XXA","X58.XXXA","M54.2","M54.5","K22.2","S63.91XA","S63.501A","Z00.00","J02.9","R10.13","R11.2","Z83.71","Z68.29","Z88.8"],"date":["2020-02-13","2020-02-13","2020-02-13","2021-07-14","2021-06-04","2020-02-13","2021-06-04","2020-02-13","2020-02-13","2020-02-28","2020-06-15","2020-02-28","2020-02-28","2021-07-19","2021-03-25","2020-04-26","2021-08-18","2021-08-18","2021-04-23","2021-03-25","2021-05-26","2021-06-23","2021-08-10","2021-06-23","2021-08-10","2021-08-18","2021-08-18","2021-01-05","2020-03-24","2021-01-05","2020-03-24","2020-04-26","2020-04-26","2020-12-05","2021-01-05","2021-01-05","2021-01-05","2021-04-01","2021-07-14","2021-08-10","2021-07-14","2021-06-01","2021-08-10","2021-06-01","2021-06-01","2020-02-14","2020-02-14","2020-03-06","2020-06-15","2019-07-31","2019-07-31","2019-07-31","2019-07-31","2019-01-18","2019-04-23","2019-01-16","2019-04-23","2019-04-23","2019-03-06","2019-03-06","2019-07-01","2019-02-10","2019-02-22","2019-03-27","2019-03-27","2019-04-17","2019-04-17","2019-07-01","2019-07-01","2019-07-01"],"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":[["","42806066305","BUSPIRONE","TAB 10MG","60","Select","Select",""],["","","TRAZODONE"," TRAZODONE ","60","Select","Select",""],["","55111046601","METOPROL","TAB 25MG ER","30","Select","Select",""],["","","HYDROXYZ","TAB 25MG","","Select","Select",""],["","42192033901","HYOSCYAMINE","SUB 0.125MG","30","Select","Select",""],["","","PROMETHAZINE"," PROMETHAZINE ","180","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","00527058610","DICYCLOMINE","CAP 10MG","60","Select","Select",""],["","","OLANZAPINE"," OLANZAPINE ","30","Select","Select",""],["","","FLUOXETINE"," FLUOXETINE ","30","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","10","Select","Select",""],["","","BUPROPN"," BUPROPN ","30","Select","Select",""],["","","GG\/CODEINE"," GG\/CODEINE ","50","Select","Select",""],["","","CHERATUSSIN"," CHERATUSSIN ","50","Select","Select",""],["","","AMOXICILLIN"," AMOXICILLIN ","14","Select","Select",""],["","","OMEPRAZOLE"," OMEPRAZOLE ","30","Select","Select",""],["","","PREVALITE"," PREVALITE ","90","Select","Select",""],["","","RANITIDINE"," RANITIDINE ","60","Select","Select",""],["","","ANUCORT-HC"," ANUCORT-HC ","28","Select","Select",""],["","","GAS"," GAS ","120","Select","Select",""],["","","BENZONATATE"," BENZONATATE ","21","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","ACETAMIN"," ACETAMIN ","168","Select","Select",""],["","","OXYCODONE"," OXYCODONE ","20","Select","Select",""],["","","ACETAMINOPHE"," ACETAMINOPHE ","168","Select","Select",""],["","","SIMETHICONE"," SIMETHICONE ","120","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","","LITHIUM","CAP 300MG","","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":""}]}]}