{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CANDACE PENICK","gend":1,"add":"1142 BILLYS LN","city":"HALIFAX","state":"VA","zip":"24558-9998","dob":"1983-06-22","age":"","mstatus":"","insh":"20033270*01","cliId":"","pno":"434\/575-5239","cno":"434\/228-0039","email":"","ename":"","eno":"","pphy":"LE, UYEN MD","ppno":"434\/572-8921","pcpadd":"1020 BILL TUCK HWY STE 900","pcpcity":"SOUTH BOSTON","pcpstate":"VA","pcpzip":24592,"pcpcounty":"","pcpid":"","pcpname":"FULLER ROBERTS OBGYN & PRIMARY CARE","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"4344463562, 4344463196","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/575-1290","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R10.2","J34.3","J30.89","Z20.2","J02.9","J01.90","J30.9","N76.0","M24.411","N92.0","S43.004A","V58.89","H65.03","B37.3","N18.3","E55.9","R53.83","J30.2","H90.0","B37.2","E66.09","R05.","L50.0","H93.8X3","L29.9","Z68.36","S43.304A","H66.91","M25.561","N92.6","R45.86","E66.9","Z30.42","N92.1","J01.41","J30.1","I10.","Z91.048","Z98.51","Z79.899","Z79.51","J06.9","R06.2","Z68.35","N76.2","L50.1","L29.8","Z91.018","R06.02","F32.0","J45.998","R51.9","M23.91"],"date":["2019-03-15","2019-08-07","2019-09-05","2021-12-20","2019-11-23","2019-11-23","2021-03-05","2021-12-20","2021-05-12","2021-07-19","2021-06-08","2019-06-04","2019-05-29","2021-08-23","2020-07-15","2021-05-10","2021-05-10","2020-09-16","2019-05-29","2019-05-29","2021-12-03","2021-03-05","2020-09-16","2020-09-16","2020-09-16","2021-12-03","2019-02-11","2019-05-17","2021-09-01","2020-06-30","2019-01-11","2019-01-11","2019-02-01","2019-07-17","2021-12-03","2021-12-03","2021-12-03","2019-05-17","2019-05-17","2019-05-17","2019-05-17","2020-08-19","2021-03-05","2020-08-19","2019-08-21","2019-09-05","2019-09-05","2019-09-05","2021-03-05","2019-12-27","2021-03-05","2021-03-05","2021-09-01"],"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":[["","","BENZONATATE","CAP 100MG","","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","00430042014","LO","TAB 40452","84","Select","Select",""],["","24658031205","DOXYCYCL","TAB 100MG","14","Select","Select",""],["","68462030529","NORETHINDRON","TAB 0.35MG","84","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","10","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","14","Select","Select",""],["","","FEXOFENADINE","TAB 180MG","","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00093226301","AMOXICILLIN","TAB 500MG","20","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","51672130406","TERCONAZOLE","CRE 0.004","45","Select","Select",""],["","","VITAMIN","TAB 5000UNIT","","Select","Select",""],["","","MONTELUKAST","CHW 5MG","","Select","Select",""],["","","ARTHRTS","TAB 650MG","","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","","LEVOFLOXACIN","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":""}]}]}