{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MELVIN   D MCCLARK","gend":0,"add":"8 WISTERIA WAY APT 4","city":"PALMYRA","state":"VA","zip":"22963-9998","dob":"1982-06-28","age":"","mstatus":"","insh":"20031761*01","cliId":"","pno":"434\/228-0341","cno":"434\/228-0341","email":"","ename":"","eno":"","pphy":"KINSELLA, LISSETTE NP","ppno":"434\/589-9030","pcpadd":"77 MARKET ST STE E","pcpcity":"PALMYRA","pcpstate":"VA","pcpzip":22963,"pcpcounty":"","pcpid":"","pcpname":"UNIVERSITY OF VIRGINIA PHYSICIANS GROUP","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/589-9040","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.0","F33.9","R07.89","E87.6","F31.2","R55.","V62.84","F25.9","M75.51","Z71.1","F25.1","S67.21XA","S09.90XA","R52.","M54.2","W19.XXXA","E16.1","E16.2","R07.9","E86.0","S32.424A","S43.402A","S62.342A","F43.10","Z00.8","F20.9","S49.92XA","F05.","F12.90","F10.929","Y90.2","Z91.19","R44.0","Z20.822","S43.52XA","W01.10XA","M25.512","R07.81","R42.","S89.91XA","X50.0XXA","R10.13","T14.8XXA","M79.603","R10.9","F17.200","F32.9","R11.10","R19.7","F17.210","Z88.8","Z91.040","Z91.013","Z88.5","Z23.","S36.90XA","R10.0","A08.4","S40.012A","S63.616A","S46.911A","S62.131A","S20.211A","W18.2XXA","S09.8XXA","S13.4XXA","S50.01XA","M25.561","Z13.31","Z74.3","Z62.810","I49.3","Z91.14","S60.221A","S60.410A"],"date":["2021-12-03","2020-02-17","2019-07-20","2019-07-20","2019-09-06","2020-02-11","2020-08-26","2020-10-16","2019-02-26","2019-02-26","2019-04-28","2021-03-23","2019-06-23","2019-06-23","2019-06-23","2019-06-23","2019-07-20","2019-07-20","2019-07-20","2019-07-20","2019-10-15","2019-12-19","2021-04-02","2021-08-15","2021-08-15","2019-04-26","2019-12-19","2020-01-30","2021-08-25","2020-02-16","2020-02-16","2020-02-16","2021-07-08","2021-07-08","2019-04-16","2019-04-16","2020-02-11","2020-02-11","2020-11-24","2021-03-17","2021-03-17","2021-08-25","2019-04-16","2019-04-16","2021-08-25","2020-08-26","2020-08-23","2021-08-25","2021-08-25","2021-08-25","2021-08-25","2021-08-25","2021-08-25","2021-08-25","2021-09-17","2019-05-13","2021-08-25","2019-10-30","2019-12-15","2021-01-12","2021-01-12","2021-03-24","2019-05-13","2019-05-13","2019-06-23","2019-06-23","2019-06-23","2019-06-23","2019-11-25","2020-08-22","2020-08-26","2020-08-26","2020-08-26","2021-03-22","2021-03-22"],"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":[["","","HYDROXYZ"," HYDROXYZ ","60","Select","Select",""],["","","LATUDA"," LATUDA ","30","Select","Select",""],["","","LITHIUM"," LITHIUM ","60","Select","Select",""],["","","QUETIAPINE"," QUETIAPINE ","30","Select","Select",""],["","","PRAZOSIN"," PRAZOSIN ","30","Select","Select",""],["","","BENZTROPINE"," BENZTROPINE ","30","Select","Select",""],["","","NAPROXEN"," NAPROXEN ","10","Select","Select",""],["","","CLINDAMYCIN"," CLINDAMYCIN ","28","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","5","Select","Select",""],["","","TRAZODONE"," TRAZODONE ","30","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","30","Select","Select",""],["","","SERTRALINE"," SERTRALINE ","30","Select","Select",""],["","","KETOROLAC"," KETOROLAC ","10","Select","Select",""],["","","AMOX\/K"," AMOX\/K ","21","Select","Select",""],["","","ONDANSETRON"," ONDANSETRON ","20","Select","Select",""],["","","CHLORHEX"," CHLORHEX ","473","Select","Select",""],["","","OXYCOD\/APAP"," OXYCOD\/APAP ","10","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","","OXCARBAZEPIN","TAB 150MG","","Select","Select",""],["","","HALOPERIDOL","TAB 5MG","","Select","Select",""],["","","TAMSULOSIN","CAP 0.4MG","","Select","Select",""],["","","CIPROFLOXACN","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":""}]}]}