{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HEATHER MCMANAMA","gend":1,"add":"172 ALTA DR","city":"STUARTS DRAFT","state":"VA","zip":"24477-9998","dob":"1997-02-02","age":"","mstatus":"","insh":"1284577*01","cliId":"","pno":"540\/949-0600","cno":"","email":"","ename":"","eno":"","pphy":"SNYDER, JOHN A DO","ppno":"540\/245-7870","pcpadd":"2570 STUARTS DRAFT HWY","pcpcity":"STUARTS DRAFT","pcpstate":"VA","pcpzip":24477,"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\/245-7871","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.5","G43.909","K21.9","G43.009","S49.91XA","M25.511","M79.601","K22.4","R10.13","Z01.419","N20.0","N83.202","R10.32","R05.","R50.9","J02.9","Z20.822","R06.02","Z88.6","Z88.5","M54.89","R39.9","G47.26","E66.9","F39.","R10.31","R10.2","R11.2","R21.","L71.8","L20.84","D22.39","L85.3","L57.8","M54.31","L23.9","F41.1","N83.201","K11.21","G47.00","Z30.46","F33.0","F33.9","F33.2","F43.10","R10.9","K52.9","G43.709","K75.81","F43.12","R10.11","NO DATA","R12.","Z88.1","Z88.8","Z87.891","Z79.899","S16.1XXA","M54.6","M54.2","Z30.017","S39.92XA","K29.70","F41.9","L28.2","K76.0","R93.2","Z87.19","Z87.42","Z87.442","S19.9XXA"],"date":["2020-06-25","2021-09-20","2021-09-20","2021-03-17","2021-04-16","2022-03-03","2021-07-12","2021-12-02","2022-04-22","2022-02-23","2020-10-27","2021-01-27","2020-10-29","2021-08-26","2021-08-26","2021-08-26","2022-04-22","2021-11-24","2022-06-30","2022-04-22","2020-10-27","2020-10-25","2021-01-27","2021-01-27","2021-01-27","2020-06-10","2020-06-10","2020-10-25","2021-09-28","2021-10-26","2021-09-28","2021-09-28","2021-10-26","2021-10-26","2019-11-13","2019-11-10","2019-03-12","2019-02-06","2019-09-08","2019-08-20","2019-04-22","2022-11-23","2019-06-20","2019-02-18","2019-06-05","2022-03-07","2022-03-07","2022-03-07","2022-03-07","2022-11-23","2022-03-03","2022-09-29","2022-04-22","2022-04-22","2022-04-22","2022-04-22","2022-06-30","2022-06-30","2022-06-30","2022-06-30","2022-02-28","2022-06-30","2022-03-03","2022-07-21","2022-09-29","2022-09-29","2022-03-03","2022-03-03","2022-03-03","2022-03-03","2022-06-30"],"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":[["","78206014501","NEXPLANON","IMP 68MG","1","Select","Select",""],["","","DICYCLOMINE","CAP 10MG","","Select","Select",""],["","68382013805","TOPIRAMATE","TAB 25MG","30","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","12","Select","Select",""],["","43547028111","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","","PANTOPRAZOLE"," PANTOPRAZOLE ","30","Select","Select",""],["","62756052169","SUMATRIPTAN","TAB 50MG","9","Select","Select",""],["","68462039710","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","6","Select","Select",""],["","","NAPROXEN"," NAPROXEN ","10","Select","Select",""],["","00067067430","LORATADINE","TAB 10MG","90","Select","Select",""],["","70954002010","PRAZOSIN","CAP 2MG","30","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00713022515","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","00093083205","CLONAZEPAM","TAB 0.5MG","60","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","30","Select","Select",""],["","70954005920","PREDNISONE","TAB 10MG","20","Select","Select",""],["","","OXYCODONE","TAB 5MG","","Select","Select",""],["","00299598035","MIRVASO","GEL 0.0033","30","Select","Select",""],["","71403000330","RHOFADE","CRE 0.01","30","Select","Select",""],["","","IBUPROFEN","TAB 400MG","","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","15","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","60","Select","Select",""],["","00713063337","METRONIDAZOL","CRE 0.0075","45","Select","Select",""],["","00713063437","MOMETASONE","CRE 0.001","45","Select","Select",""],["","45802073684","CLINDAMY\/BEN","GEL 1.2-5%","45","Select","Select",""],["","16110086930","AZELEX","CRE 0.2","30","Select","Select",""],["","53489064701","DOXYCYCLINE","TAB 20MG","60","Select","Select",""],["","57237001930","DULOXETINE","CAP 60MG","30","Select","Select",""],["","","DIAZEPAM","TAB 5MG","","Select","Select",""],["","","MILI","TAB 0.25\/35","","Select","Select",""],["","","TAMSULOSIN","CAP 0.4MG","","Select","Select",""],["","","CEPHALEXIN","CAP 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":""}]}]}