{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KRISTY   R BATES","gend":1,"add":"1622 12TH ST","city":"VICTORIA","state":"VA","zip":"23974-9998","dob":"1980-11-03","age":"","mstatus":"","insh":"7294042*01","cliId":"","pno":"434\/390-2083","cno":"","email":"","ename":"","eno":"","pphy":"BASHORE, RANDALL T MD","ppno":"434\/581-3271","pcpadd":"RT 15 SOUTH","pcpcity":"NEW CANTON","pcpstate":"VA","pcpzip":23123,"pcpcounty":"","pcpid":"","pcpname":"CENTRAL VIRGINIA HEALTH SERVICES INC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/581-1105","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.5","M20.21","M76.71","S86.391A","G60.9","M67.471","N39.0","K59.00","Z87.891","F41.1","Z71.89","Z71.3","K13.79","S89.91XA","S93.401A","W10.9XXA","F33.1","F98.8","J40.","F17.200","Z20.828","NO DATA","R53.83","F41.9","J00.","F41.8","K02.9","Z09.","M25.561","M25.571","M25.562","J20.9","M79.0"],"date":["2020-05-31","2019-04-09","2019-04-09","2019-04-09","2019-04-09","2019-04-09","2020-05-31","2020-05-31","2020-05-31","2020-04-22","2020-04-22","2020-04-22","2019-06-12","2019-07-02","2019-07-02","2019-07-02","2020-04-22","2020-04-22","2020-11-16","2020-11-16","2020-11-16","2020-11-16","2020-11-16","2020-02-14","2020-03-04","2020-02-25","2020-02-25","2019-07-03","2019-07-03","2019-07-03","2020-01-29","2020-03-10","2020-11-16"],"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":[["","","CITALOPRAM"," CITALOPRAM ","30","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","15","Select","Select",""],["","","GABAPENTIN"," GABAPENTIN ","120","Select","Select",""],["","","LORAZEPAM"," LORAZEPAM ","60","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","","CHLORHEX"," CHLORHEX ","473","Select","Select",""],["","","PREDNISONE","TAB 20MG","","Select","Select",""],["","","VIRTUSSIN","SOL 100-10\/5","","Select","Select",""],["","","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","","ALPRAZOLAM","TAB 0.5MG","","Select","Select",""],["","","PAROXETINE","TAB 10MG","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","","ACETAMINOPHE","TAB 325MG","","Select","Select",""],["","","IPRATROPIUM","SPR 0.0006","","Select","Select",""],["","","GG\/CODEINE","SOL 100-10\/5","","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","30","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","","PROAIR","AER ","","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":""}]}]}