{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MELODY   B THOMASSON","gend":1,"add":"4716 OXFORD ST","city":"LYNCHBURG","state":"VA","zip":"24502-9998","dob":"1994-03-02","age":"","mstatus":"","insh":"2206665*01","cliId":"","pno":"434\/439-0873","cno":"","email":"","ename":"","eno":"","pphy":"WEEKS, LAURA PA","ppno":"434\/200-7210","pcpadd":"1901 TATE SPRINGS RD","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":24501,"pcpcounty":"","pcpid":"","pcpname":"CENTRA MEDICAL GROUP LLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/200-3265","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H10.9","R39.9","N39.0","F33.2","F41.1","J06.9","J10.1","R68.89","R09.81","B34.9","J02.9","N94.10","Z11.3","Z30.40","J18.9","J02.0","F90.9","Z23.","R30.0","B02.9","R50.9","B00.1","Z20.828","M54.5","R11.2","N87.9","R19.7","J45.909","Z97.5","R87.612","M54.32","M54.31"],"date":["2021-03-17","2021-10-19","2021-06-27","2021-06-29","2021-06-29","2021-01-18","2020-03-11","2020-02-06","2020-09-27","2020-09-27","2021-01-18","2020-12-17","2020-12-17","2020-02-14","2020-03-14","2020-03-14","2021-06-29","2021-02-17","2021-10-19","2020-03-11","2020-03-11","2021-01-18","2021-08-30","2019-10-09","2019-11-22","2019-08-07","2019-11-22","2019-11-22","2019-11-22","2019-12-10","2019-08-27","2019-08-27"],"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":[["","64764072030","TRINTELLIX","TAB 5MG","30","Select","Select",""],["","24208031510","POLYMYXIN","SOL TRIMETHP","10","Select","Select",""],["","","BUPROPN"," BUPROPN ","30","Select","Select",""],["","","ARIPIPRAZOLE"," ARIPIPRAZOLE ","30","Select","Select",""],["","","METHYLPHENID","TAB 10MG","","Select","Select",""],["","13107003134","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","00527551537","AMPHET\/DEXTR","CAP 30MG ER","30","Select","Select",""],["","54092039101","ADDERALL","CAP 30MG","30","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","120","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","65162068110","PHENAZOPYRID","TAB 100MG","12","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","10","Select","Select",""],["","68462011944","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","","VALACYCLOVIR","TAB 1GM","","Select","Select",""],["","","ESCITALOPRAM","TAB 10MG","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","","OSELTAMIVIR","CAP 75MG","","Select","Select",""],["","","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","","RITALIN","TAB 10MG","","Select","Select",""],["","","METRONIDAZOL","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":""}]}]}