{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JEREMIAH   D BYRD","gend":0,"add":"5857 THREE CREEK ROAD","city":"GLADYS","state":"VA","zip":"24554-9998","dob":"2003-03-04","age":"","mstatus":"","insh":"8623953*01","cliId":"","pno":"434\/609-2021","cno":"","email":"","ename":"","eno":"","pphy":"COLLINS, DEBRA NP","ppno":"434\/376-2325","pcpadd":"104 CAROLINA AVE","pcpcity":"BROOKNEAL","pcpstate":"VA","pcpzip":24528,"pcpcounty":"","pcpid":"","pcpname":"CENTRA MEDICAL GROUP LLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/376-2081","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F91.8","F31.75","S09.90XA","S59.902A","F90.0","H66.90","J45.31","R05.","R06.2","F91.9","B34.9","I10.","K21.9","Z04.1","Z48.02","U07.1","J03.01","J35.2","G47.30","F90.9","R63.4","M25.562","M25.561","J02.0","J02.9","J35.1","R06.83","J30.9","M25.522","S00.93XA","S00.212A","S80.212A","S60.512A","E78.5","J45.909","Z79.1","Z79.51","Z79.899","Z82.49","R10.9","R11.2","R50.9","R19.7","R68.83","J45.901","R06.02","R68.89","H66.91","J03.90","M22.2X1","M22.2X2","S50.02XA","V58.89","J32.9","M22.8X2","G89.29","R10.31","R14.3","J45.21","A08.4","J35.3","L25.9","R03.0","E78.00","R74.9","R79.89"],"date":["2021-05-07","2021-12-17","2020-11-14","2020-11-14","2019-06-10","2019-03-20","2019-05-03","2019-05-03","2019-05-03","2019-09-27","2019-09-24","2020-11-17","2020-11-14","2020-11-17","2020-11-17","2021-07-14","2019-07-16","2019-07-16","2019-07-16","2019-09-11","2019-09-11","2020-01-29","2020-01-29","2019-04-23","2019-04-23","2019-04-23","2019-04-23","2020-10-27","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2019-05-01","2019-05-01","2019-05-01","2019-05-01","2019-05-01","2019-05-01","2019-05-01","2019-01-28","2019-01-28","2019-04-09","2019-09-30","2019-09-30","2019-03-28","2019-04-11","2019-08-30","2020-01-29","2020-01-29","2021-05-07","2021-05-07","2019-05-03","2019-06-20","2019-07-16","2020-06-26","2020-06-26","2020-10-30","2020-10-30","2020-10-30"],"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":[["","","PROAIR"," PROAIR ","8","Select","Select",""],["","","VYVANSE"," VYVANSE ","30","Select","Select",""],["","","ZIPRASIDONE"," ZIPRASIDONE ","60","Select","Select",""],["","","ESCITALOPRAM"," ESCITALOPRAM ","45","Select","Select",""],["","","GUANFACINE"," GUANFACINE ","30","Select","Select",""],["","","BUPROPN"," BUPROPN ","30","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","17","Select","Select",""],["","","AZITHROMYCIN"," AZITHROMYCIN ","6","Select","Select",""],["","","TAMIFLU"," TAMIFLU ","10","Select","Select",""],["","","WIXELA"," WIXELA ","60","Select","Select",""],["","","CETIRIZINE"," CETIRIZINE ","30","Select","Select",""],["","","AMOXICILLIN"," AMOXICILLIN ","20","Select","Select",""],["","","ONDANSETRON"," ONDANSETRON ","15","Select","Select",""],["","","OXYCODONE"," OXYCODONE ","210","Select","Select",""],["","","NAPROXEN"," NAPROXEN ","10","Select","Select",""],["","","CEFDINIR"," CEFDINIR ","20","Select","Select",""],["","","PENICILLN"," PENICILLN ","40","Select","Select",""],["","","IBU"," IBU ","90","Select","Select",""],["","","ADVAIR"," ADVAIR ","60","Select","Select",""],["","","PROMETHAZINE"," PROMETHAZINE ","180","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","75","Select","Select",""],["","","SYMBICORT"," SYMBICORT ","10","Select","Select",""],["","","OMEPRAZOLE"," OMEPRAZOLE ","30","Select","Select",""],["","","AMLODIPINE"," AMLODIPINE ","30","Select","Select",""],["","","BENZONATATE"," BENZONATATE ","30","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","400","Select","Select",""],["","","MUPIROCIN"," MUPIROCIN ","22","Select","Select",""],["","","HYDROXYZ","TAB 25MG","","Select","Select",""],["","","DICLOFENAC","TAB 75MG DR","","Select","Select",""],["","","FLUTIC\/SALME","AER 100\/50","","Select","Select",""],["","","MONTELUKAST","TAB 10MG","","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","","APAP\/CODEINE","TAB 300-30MG","","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":""}]}]}