{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAVID FERRELL JR","gend":0,"add":"252 PARKER RD APT 8","city":"DANVILLE","state":"VA","zip":"24540-9998","dob":"1975-03-27","age":"","mstatus":"","insh":"20046092*01","cliId":"","pno":"434\/709-8151","cno":"","email":"","ename":"","eno":"","pphy":"STEPHENS, AMBER L DO","ppno":"434\/799-4488","pcpadd":"SUITE 201 109 BRIDGE STREET","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"DANVILLE PHYSICIAN PRACTICES LLC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/773-6977","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.3","F25.0","R10.84","R52.","J44.1","J45.41","J80.","R06.02","R06.89","R06.2","I10.","R10.9","N20.0","J45.901","Z20.822","F25.1","F31.9","Z72.0","J45.21","J96.01","F17.210","E66.9","E78.5","F41.9","F19.10","Z79.899","Z68.35","Z87.442","R11.2","J45.31","Z87.891","J45.909","F32.9","V62.84","F31.5","E83.39","D72.829","Z90.49","Z09.","Z87.09","D72.828","J45.40","R06.9","J45.902","R06.00","Z79.891","F14.10","J41.1","J30.1","R13.19","R00.0","N20.1","H25.13","H35.413","K02.9","R22.0","J96.10","J96.02","I16.0","J96.21","R65.10","R73.03","E66.01","Z68.33","Z99.81","Z79.52","R05.9","R65.11","Z91.14","R09.02"],"date":["2020-09-02","2020-09-28","2020-08-13","2020-08-13","2021-03-23","2022-04-03","2022-03-02","2022-04-03","2022-04-04","2022-05-13","2022-05-13","2021-09-02","2021-09-02","2022-05-13","2022-04-04","2020-07-06","2022-04-21","2021-09-02","2021-05-15","2022-03-05","2021-05-15","2021-05-15","2022-04-21","2022-04-21","2021-05-15","2022-04-21","2021-05-15","2022-04-21","2021-09-02","2020-11-23","2022-05-13","2022-05-13","2020-04-02","2020-04-06","2020-04-06","2021-09-30","2021-09-30","2022-04-21","2021-04-15","2021-04-15","2021-04-15","2021-10-27","2022-04-04","2022-04-21","2021-12-27","2020-03-04","2020-05-11","2021-10-27","2021-10-27","2021-10-27","2022-04-21","2019-01-11","2019-01-18","2019-01-18","2019-02-05","2019-02-05","2022-05-07","2022-03-05","2022-04-04","2022-04-21","2022-04-21","2022-04-21","2022-04-21","2022-04-21","2022-05-13","2022-04-21","2022-04-03","2022-04-04","2022-04-04","2022-03-02"],"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":[["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","","IPRATROPIUM\/","SOL ALBUTER","","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00085113204","PROVENTIL","AER HFA","7","Select","Select",""],["","","PREDNISONE","TAB 50MG","","Select","Select",""],["","57237000299","HYDROCHLOROT","CAP 12.5MG","30","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","31722072690","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","","QUETIAPINE","TAB 100MG","","Select","Select",""],["","00173060202","FLOVENT","AER 100MCG","60","Select","Select",""],["","00186091706","PULMICORT","INH 90MCG","2","Select","Select",""],["","","NICOTINE","DIS 14MG\/24H","","Select","Select",""],["","83490031065","VIOS","MIS SYSTEM","1","Select","Select",""],["","55111012305","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","00173089310","TRELEGY","AER ELLIPTA","60","Select","Select",""],["","62175011843","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","63824005634","MUCINEX","TAB 30-600ER","40","Select","Select",""],["","00536132701","ACETAMINOPHE","TAB 325MG","50","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","","BUSPIRONE","TAB 10MG","","Select","Select",""],["","","MIRTAZAPINE","TAB 15MG","","Select","Select",""],["","","SERTRALINE","TAB 50MG","","Select","Select",""],["","","RISPERIDONE","TAB 0.5MG","","Select","Select",""],["","","TRAZODONE","TAB 100MG","","Select","Select",""],["","","VENLAFAXINE","CAP 150MG ER","","Select","Select",""],["","","KETOROLAC","TAB 10MG","","Select","Select",""],["","69238110305","IBUPROFEN","TAB 800MG","28","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","16","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","00363033355","ARTHRTS","TAB 650MG","28","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","57237004105","PENICILLN","TAB 500MG","56","Select","Select",""],["","68382031910","TRAMADOL","TAB 50MG","12","Select","Select",""],["","55111068305","IBU","TAB 600MG","30","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","30","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":""}]}]}