{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LATOYA   M BOOKER","gend":1,"add":"714 TAYLOR ST","city":"LYNCHBURG","state":"VA","zip":"24504-9998","dob":"1990-06-24","age":"","mstatus":"","insh":"7605536*01","cliId":"","pno":"434\/425-3955","cno":"434\/425-3955","email":"","ename":"","eno":"","pphy":"STIRGWOLT, JENNIFER K DO","ppno":"434\/200-3366","pcpadd":"800 5TH STREET","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":24504,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/847-2521","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L20.84","B20.","R30.0","O26.891","O99.891","Z3A.38","Z91.14","Z21.","A60.9","R87.612","O20.0","O23.41","Z3A.01","O98.72","D57.3","O99.02","O99.824","Z37.0","Z87.11","Z91.013","O80.","Z20.822","Z11.3","Z30.9","L70.0","L71.8","L21.8","N90.89","D06.9","Z30.09","R10.9","O46.90","N30.01","N91.2","O98.711","V23.89","Z3A.10","Z23.","N87.9","N92.6","G56.03","G56.01","Z3A.00","Z3A.40","I10.","J40.","J02.9","J30.2","R05.9","R09.89","Z20.828","R51.9","Z3A.39","L30.9","R10.32","Z33.1","N76.4","Z01.419","N89.8","N30.00","M79.632","R20.0","R20.2","J01.10","G44.52"],"date":["2021-07-12","2022-08-11","2020-11-09","2020-11-09","2021-06-04","2021-06-04","2022-08-11","2021-06-15","2021-05-11","2020-03-31","2020-12-07","2020-10-31","2020-10-31","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-06-15","2021-09-20","2022-04-26","2022-04-26","2022-06-30","2022-06-30","2022-06-30","2020-02-19","2020-05-28","2020-08-18","2020-10-31","2021-01-11","2020-11-09","2020-11-24","2020-11-24","2020-11-24","2020-11-24","2021-03-18","2020-05-12","2020-10-14","2021-05-12","2021-05-19","2021-06-15","2021-06-15","2022-06-10","2022-03-01","2022-06-10","2022-06-10","2022-06-10","2022-06-10","2020-09-07","2021-06-11","2021-06-11","2020-02-07","2020-10-31","2020-10-31","2020-02-03","2020-02-05","2020-02-11","2020-08-27","2021-05-07","2021-05-07","2021-05-07","2021-09-15","2021-09-15"],"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":[]},{"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":[["","50111033401","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","65862053650","LEVOFLOXACIN","TAB 250MG","14","Select","Select",""],["","68462030929","NORGEST\/ETHI","TAB 0.25\/35","28","Select","Select",""],["","69230031703","ALLERGY","TAB 10MG","30","Select","Select",""],["","57237003101","AMOXICILLIN","CAP 500MG","20","Select","Select",""],["","62332042631","BENZONATATE","CAP 100MG","90","Select","Select",""],["","69618006106","GUAIFENESIN","TAB 400MG","60","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","73473030060","CLINDAMYCIN","GEL 0.01","60","Select","Select",""],["","68180065208","DOXYCYC","CAP 100MG","60","Select","Select",""],["","61958250101","BIKTARVY","TAB ","30","Select","Select",""],["","00093321992","KETOCONAZOLE","CRE 0.02","60","Select","Select",""],["","00168000615","TRIAMCINOLON","OIN 0.001","30","Select","Select",""],["","31722070430","VALACYCLOVIR","TAB 500MG","40","Select","Select",""],["","61442011201","ACYCLOVIR","TAB 400MG","30","Select","Select",""],["","43386009662","CLOBETASOL","OIN 0.0005","60","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","12","Select","Select",""],["","68180016006","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","61958110101","COMPLERA","TAB ","30","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","5","Select","Select",""],["","00555901658","SPRINTEC","TAB 28 DAY","28","Select","Select",""],["","33332032001","AFLURIA","INJ 2020-21","0","Select","Select",""],["","65162074510","PROMETHAZINE","TAB 12.5MG","30","Select","Select",""],["","68180044101","CEPHALEXIN","SUS 250\/5ML","200","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":""}]}]}