{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RICKEY   O MOON","gend":0,"add":"906 9TH ST APT F12","city":"ALTAVISTA","state":"VA","zip":"24517-9998","dob":"1959-10-02","age":"","mstatus":"","insh":"20032306*01","cliId":"","pno":"434\/369-4955","cno":"","email":"","ename":"","eno":"","pphy":"TUCKER, MELISSA NP","ppno":"434\/309-1165","pcpadd":"1280 A MAIN STREET","pcpcity":"ALTAVISTA","pcpstate":"VA","pcpzip":24517,"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\/200-1671","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M19.031","M20.41","M20.42","L60.0","E11.41","M79.674","M79.675","L03.032","J44.9","Z87.891","E11.65","I10.","E78.2","M79.641","M79.642","C61.","E66.01","Z72.0","M54.5","U07.1","F17.200","J30.9","R91.1","G47.30","M51.36","J40.","NO DATA","R05.9","M79.605","N52.9","M54.16","M54.06","M62.830","M25.531","E11.9","H52.4","Z12.11","Z86.010","K55.20","K57.30","Z68.38","Z51.0","E78.5","Z79.82","Z79.899","Z79.84","Z80.42","M54.17","M54.32","M79.604","R20.2","G47.33","M51.37","M43.07","F43.0","M51.16","M79.3","B35.1","Z23.","E66.9","C34.90","M62.81","F17.210","K62.5","E80.5","K64.8","K64.9"],"date":["2021-03-10","2021-06-25","2021-06-25","2021-06-25","2021-06-25","2021-06-25","2021-06-25","2020-09-30","2021-12-17","2021-10-21","2021-10-21","2021-08-25","2020-11-23","2020-11-23","2020-11-23","2021-08-05","2021-10-21","2021-10-21","2021-06-15","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-09-21","2021-10-21","2021-10-27","2021-10-27","2021-06-15","2021-08-05","2020-03-04","2020-03-04","2020-03-04","2021-01-13","2021-08-23","2021-08-23","2021-08-25","2021-08-25","2021-08-25","2021-08-25","2021-08-25","2019-11-01","2019-11-01","2019-11-01","2019-11-01","2019-11-01","2019-11-01","2019-04-11","2019-03-06","2019-03-13","2019-03-13","2019-12-18","2019-04-11","2019-04-11","2019-04-11","2019-06-18","2019-06-18","2019-11-08","2019-06-12","2019-06-12","2019-06-12","2019-05-22","2019-08-15","2019-01-11","2019-01-11","2019-01-11","2019-01-11"],"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":[["","50228018005","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","120","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","68645055854","LISINOP\/HCTZ","TAB 20-25MG","90","Select","Select",""],["","31722071101","SILDENAFIL","TAB 100MG","5","Select","Select",""],["","68645054659","METFORMIN","TAB 1000MG","180","Select","Select",""],["","59779030603","CVS","POW ","510","Select","Select",""],["","50428166363","BISACODYL","TAB 5MG EC","2","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","68645048054","ATORVASTATIN","TAB 10MG","90","Select","Select",""],["","00378932032","WIXELA","AER 100\/50","60","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","10","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","66993058497","FLUTIC\/SALME","AER 100\/50","60","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","00173069500","ADVAIR","AER 100\/50","60","Select","Select",""],["","70436005901","BUPROPION","TAB 150MG SR","60","Select","Select",""],["","00054418625","DEXAMETHASON","TAB 6MG","10","Select","Select",""],["","43386031214","GAVILAX","POW ","510","Select","Select",""],["","57896048930","POLYETH","POW 3350 NF","510","Select","Select",""],["","","NARCAN","SPR ","","Select","Select",""],["","","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","","CELECOXIB","CAP 200MG","","Select","Select",""],["","00832105415","BACLOFEN","TAB 10MG","90","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","42","Select","Select",""],["","00573284010","PREPARATIO","GEL ","54","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}