{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JALEESA   J BARKSDALE","gend":1,"add":"164 NEW HOPE WAY","city":"DANVILLE","state":"VA","zip":"24541-9998","dob":"1989-10-11","age":"","mstatus":"","insh":"7377150*01","cliId":"","pno":"336\/430-2239","cno":"434\/792-0424","email":"","ename":"","eno":"","pphy":"SHARP, CASEY NP","ppno":"434\/835-4876","pcpadd":"949 PINEY FOREST ROAD","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"GO DOCS","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/835-4875","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N76.0","R10.10","K21.9","E66.9","F41.9","F13.20","R45.4","F32.9","Z51.81","H00.025","H35.89","R63.0","R25.2","R42.","R26.89","F41.1","H81.11","J11.1","S50.861A","S40.861A","J01.90","R51.","H73.891","R63.8","B49.","J30.9","R09.81","Z30.42","Z30.09","R53.1","R07.9","Z34.81","F41.0","R00.2","F33.0","B37.2","H43.313","Z32.01","Z34.83","Z23.","O80.","J34.89","O99.02","Z37.0","D50.9","Z3A.38","M25.539","Z79.899","M25.531","M79.604","H66.92","F33.1","H81.12","Z00.00","B37.3","N92.6","R39.9","L21.8","O99.340"],"date":["2020-10-07","2020-10-07","2021-07-26","2021-10-21","2021-12-01","2019-08-28","2021-12-01","2021-12-01","2021-12-01","2020-02-27","2020-02-27","2020-10-07","2020-04-02","2019-09-05","2019-09-05","2019-09-05","2019-09-05","2019-12-20","2019-04-27","2019-04-27","2019-07-16","2019-07-16","2019-07-16","2021-07-26","2021-07-26","2020-08-30","2020-08-30","2021-11-04","2021-11-04","2021-10-01","2021-10-01","2020-10-22","2021-12-01","2019-07-09","2019-04-30","2020-03-04","2020-03-18","2020-09-22","2021-10-01","2021-10-21","2021-04-30","2020-02-18","2021-04-30","2021-04-30","2021-04-30","2021-04-30","2021-05-12","2019-04-27","2019-04-27","2019-07-23","2019-02-11","2019-04-03","2019-06-19","2020-02-04","2021-08-26","2019-06-04","2020-10-07","2020-11-30","2021-02-25"],"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":[["","","ESCITALOPRAM"," ESCITALOPRAM ","30","Select","Select",""],["","","ALPRAZOLAM"," ALPRAZOLAM ","90","Select","Select",""],["","","NASAL"," NASAL ","30","Select","Select",""],["","","BUPROPION"," BUPROPION ","60","Select","Select",""],["","","HYDROXYZ"," HYDROXYZ ","30","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","21","Select","Select",""],["","","AMOXICILLIN"," AMOXICILLIN ","20","Select","Select",""],["","","CVS"," CVS ","30","Select","Select",""],["","","OMEPRAZOLE"," OMEPRAZOLE ","30","Select","Select",""],["","","FLUCONAZOLE"," FLUCONAZOLE ","1","Select","Select",""],["","","PENICILLN"," PENICILLN ","28","Select","Select",""],["","","AZITHROMYCIN"," AZITHROMYCIN ","1","Select","Select",""],["","","MUPIROCIN"," MUPIROCIN ","22","Select","Select",""],["","","MECLIZINE"," MECLIZINE ","30","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","16","Select","Select",""],["","","OSELTAMIVIR"," OSELTAMIVIR ","10","Select","Select",""],["","","CYPROHEPTAD","TAB 4MG","","Select","Select",""],["","","ONDANSETRON","TAB 4MG","","Select","Select",""],["","","MONTELUKAST","CHW 5MG","","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","","PROMETHAZINE","TAB 25MG","","Select","Select",""],["","","ASPIRIN","TAB 81MG EC","","Select","Select",""],["","","FLUOCINONIDE","SOL 0.0005","","Select","Select",""],["","","MOMETASONE","SPR 50MCG","","Select","Select",""],["","","BACLOFEN","TAB 10MG","","Select","Select",""],["","","HYDROCORT","CRE 0.025","","Select","Select",""],["","","KETOCONAZOLE","SHA 0.02","","Select","Select",""],["","","FLUZONE","INJ 2020-21","","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":""}]}]}