{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHRISTINA   L JONES","gend":1,"add":"14021 ROCKFORD SCHOOL ROAD","city":"HURT","state":"VA","zip":"24563-9998","dob":"1988-08-27","age":"","mstatus":"","insh":"20030204*01","cliId":"","pno":"434\/333-8629","cno":"434\/333-8629","email":"","ename":"","eno":"","pphy":"WILGUS, ALEXANDER M MD","ppno":"434\/656-1274","pcpadd":"1220 WEST GRETNA RD","pcpcity":"GRETNA","pcpstate":"VA","pcpzip":24557,"pcpcounty":"","pcpid":"","pcpname":"CENTRA MEDICAL GROUP LLC","plan":"OHP","program":"MEDICAID","lob":"OHCC","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":["R51.","J45.909","F31.9","F17.210","R21.","Z88.6","M54.12","S83.512A","V86.59XA","Z72.0","R20.2","R07.9","M50.30","M96.0","F41.8","J45.901","J06.9","M47.816","G89.29","Z79.899","Z12.11","Z86.010","K64.8","L29.9","F41.9","M51.26","Z98.1","M23.92","L50.9","S00.83XA","N92.6","R45.86","R60.9","R60.0","J00.","M50.33","S81.812A","Z23.","Y92.89","W13.4XXA","M25.462","M25.562"],"date":["2019-03-18","2020-03-02","2020-02-23","2019-08-27","2019-03-09","2019-03-09","2019-08-05","2021-11-16","2021-11-16","2019-01-30","2019-05-16","2019-05-16","2020-03-02","2019-08-05","2019-08-27","2020-02-06","2020-02-06","2020-03-02","2020-03-02","2019-02-16","2020-12-02","2020-12-02","2020-12-02","2020-02-23","2020-12-02","2019-05-31","2019-05-31","2021-10-18","2019-02-01","2019-03-15","2019-08-12","2019-08-12","2019-03-18","2019-03-18","2019-03-18","2019-07-17","2021-07-24","2021-07-24","2021-07-24","2021-07-24","2021-10-11","2021-10-11"],"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":[["","","OLANZA\/FLUOX"," OLANZA\/FLUOX ","30","Select","Select",""],["","","MONTELUKAST"," MONTELUKAST ","30","Select","Select",""],["","","VENTOLIN"," VENTOLIN ","18","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","8","Select","Select",""],["","","FAMOTIDINE"," FAMOTIDINE ","14","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","5","Select","Select",""],["","","TRAZODONE"," TRAZODONE ","90","Select","Select",""],["","","ALLERGY"," ALLERGY ","21","Select","Select",""],["","","METHYLPRED"," METHYLPRED ","21","Select","Select",""],["","","HYDROCORT"," HYDROCORT ","28","Select","Select",""],["","","BUSPIRONE"," BUSPIRONE ","90","Select","Select",""],["","","TRAMADOL","TAB 50MG","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","","CVS","POW ","","Select","Select",""],["","","MIRALAX","POW 3350 NF","","Select","Select",""],["","","DICLOFEN","TAB 50MG","","Select","Select",""],["","","BISACODYL","TAB 5MG EC","","Select","Select",""],["","","SUPREP","SOL PREP KIT","","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":""}]}]}