{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHANNON  L DOVE","gend":1,"add":"678 EDMONDS ST","city":"DANVILLE","state":"VA","zip":24541,"dob":"1977-06-21","age":"","mstatus":"","insh":"8606714*01","cliId":"","pno":"434\/797-1014","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"434\/799-4488","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"DANVILLE PHYSICIAN PRACTICES LLC","plan":"OHP","program":"Medicaid","lob":"M4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/773-6977","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25.531","Z79.4","E11.9","Z85.048","K56.41","R11.2","E08.65","M62.830","G89.29","M54.9","Z88.6","Z88.8","F17.210","M54.5","J01.90","R51.","H92.01","R11.11","R10.84","L03.115","L02.818","M79.645","L02.91","Z08.","Z85.038","K64.4","C20.","E11.65","N12.","E86.0","Z09.","C18.7","L03.311","Z85.9","C19.","K29.70","K29.80","Z88.5","Z79.84","Z98.890","H52.4","E11.3391","E11.3312","H52.223","K29.90","D12.3","N10.","E87.1","D49.0","E83.42","K63.5","Z91.018","D12.8","Z01.810","K38.0"],"date":["2020-10-30","2020-10-30","2020-10-30","2020-06-26","2020-04-16","2020-04-16","2020-04-16","2020-07-14","2020-07-14","2020-07-14","2020-07-14","2020-07-14","2020-07-14","2020-07-14","2020-02-04","2020-02-04","2020-02-04","2020-04-16","2020-04-16","2020-05-25","2020-03-30","2020-04-08","2020-04-08","2020-06-26","2020-06-26","2020-06-26","2020-06-09","2019-05-29","2019-05-10","2019-05-10","2019-06-07","2019-09-11","2019-12-26","2019-12-26","2019-05-24","2019-05-24","2019-05-24","2019-05-24","2019-05-24","2019-05-24","2019-06-25","2019-06-25","2019-06-25","2019-06-25","2019-05-10","2019-05-16","2019-05-06","2019-05-06","2019-05-06","2019-05-06","2019-05-06","2019-05-06","2019-05-16","2019-05-22","2019-05-24"],"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":[["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","","SMZ\/TMP","TAB 800-160","","Select","Select",""],["","","PHENADOZ","SUP 25MG","","Select","Select",""],["","08396901534","RELION","MIS 31GX6MM","100","Select","Select",""],["","","PREDNISONE","TAB 20MG","","Select","Select",""],["","","BD  PEN NEEDL","MIS 31GX5MM","","Select","Select",""],["","53885044801","ONETOUCH","KIT ULTRA 2","1","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","40","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","","METOCLOPRAM","TAB 10MG","","Select","Select",""],["","","CYCLOBENZAPR","TAB 5MG","","Select","Select",""],["","","TYLENOL","TAB 325MG","","Select","Select",""],["","","HYDROCOD\/IBU","TAB 7.5-200","","Select","Select",""],["","","ACETAMINOPHN","TAB 500MG","","Select","Select",""],["","","CHLORHEX","SOL 0.0012","","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","10","Select","Select",""],["","00904645780","DOK","CAP 100MG","40","Select","Select",""],["","49035032910","MAG","SOL LEMON","592","Select","Select",""],["","68645053959","METFORMIN","TAB 500MG","60","Select","Select",""],["","68645055054","LISINOPRIL","TAB 2.5MG","30","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","3","Select","Select",""],["","68645048054","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","5","Select","Select",""],["","00093117701","NEOMYCIN","TAB 500MG","6","Select","Select",""],["","12843003520","STOOL","CAP 100MG","40","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":""}]}]}