{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KATIA   S LEGRAND","gend":1,"add":"112 GREENWOOD LN APT B","city":"DANVILLE","state":"VA","zip":"24540-9998","dob":"1989-06-04","age":"","mstatus":"","insh":"7375727*01","cliId":"","pno":"434\/710-3787","cno":"","email":"","ename":"","eno":"","pphy":"GATEWOOD, TINA PA","ppno":"434\/791-4122","pcpadd":"705 MAIN ST","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"PIEDMONT ACCESS TO HEALTH SERVICES INC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/791-4126","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.32","O20.9","Z3A.08","O21.0","Z88.8","Z72.0","Z20.822","NO DATA","U07.1","K51.50","N83.291","Z20.828","J06.9","O42.02","O69.81X1","Z37.0","Z3A.37","S01.511A","R10.33","N39.0","B34.9","S05.02XA","Z88.5","Z87.891","H57.12","R00.0","I10.","F10.929","R10.31","O26.90","J34.89","L66.2","N76.0","F41.1","O23.591","O26.891","R10.30","Z3A.01","R52.","R40.4","O47.9","Z39.1","S93.401A","O99.824","O99.02","D64.9","O91.12","O80.","R19.7","J20.9","O99.611","K57.32","J02.9","J30.9","F33.3","J09.X2","F17.210","R10.13"],"date":["2020-07-05","2020-12-26","2020-12-26","2020-12-26","2021-12-29","2020-12-26","2021-12-29","2021-08-21","2021-09-10","2020-05-24","2020-05-24","2020-10-08","2021-12-29","2021-07-18","2021-07-18","2021-07-18","2021-07-18","2021-09-21","2020-02-27","2020-02-27","2021-12-29","2020-05-09","2020-05-09","2020-05-09","2020-05-09","2020-08-10","2021-07-18","2020-08-10","2020-11-21","2020-11-21","2021-09-10","2020-04-29","2020-10-20","2020-05-13","2020-11-21","2020-11-21","2020-11-21","2020-11-21","2021-07-18","2021-07-18","2021-07-18","2021-08-18","2021-09-02","2021-07-18","2021-07-18","2021-07-18","2021-07-18","2021-07-18","2021-12-29","2021-12-29","2020-06-05","2020-06-05","2021-12-29","2019-05-24","2019-01-13","2019-03-04","2019-03-04","2019-01-26"],"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":[["","50428047392","CVS","CAP 25MG","60","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","30","Select","Select",""],["","63402030230","LATUDA","TAB 20MG","30","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","12","Select","Select",""],["","","PROMETHAZINE"," PROMETHAZINE ","240","Select","Select",""],["","","METRONIDAZOL"," METRONIDAZOL ","14","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","14","Select","Select",""],["","0",""," ","200","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","30","Select","Select",""],["","","CIPROFLOXACN"," CIPROFLOXACN ","14","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","METHYLPRED"," METHYLPRED ","21","Select","Select",""],["","","LORATADINE"," LORATADINE ","30","Select","Select",""],["","","QUETIAPINE"," QUETIAPINE ","30","Select","Select",""],["","","TAMIFLU"," TAMIFLU ","10","Select","Select",""],["","","OSELTAMIVIR"," OSELTAMIVIR ","10","Select","Select",""],["","","CETIRIZINE"," CETIRIZINE ","30","Select","Select",""],["","","NAPROXEN"," NAPROXEN ","10","Select","Select",""],["","","FLUCONAZOLE"," FLUCONAZOLE ","1","Select","Select",""],["","","ERYTHROMYCIN","OIN OP","","Select","Select",""],["","","ETONOGESTREL","MIS ETHY EST","","Select","Select",""],["","","DOXYCYCL","TAB 100MG","","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","","NITROFURANTN","CAP 100MG","","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":""}]}]}