{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEBORAH   K STEGER","gend":1,"add":"101 SPROUSE S CORNER ROAD","city":"DILLWYN","state":"VA","zip":"23936-9998","dob":"1974-02-01","age":"","mstatus":"","insh":"9080953*01","cliId":"","pno":"434\/414-8044","cno":"","email":"","ename":"","eno":"","pphy":"ARNOLD, ADAM J NP","ppno":"434\/581-3271","pcpadd":"25892 N JAMES MADISON HIGHWAY","pcpcity":"NEW CANTON","pcpstate":"VA","pcpzip":23123,"pcpcounty":"","pcpid":"","pcpname":"CENTRAL VIRGINIA HEALTH SERVICES INC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/581-1105","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J06.9","R06.2","J98.8","B97.89","R25.1","F41.1","R94.2","R91.8","R59.0","G47.19","Z77.22","R07.9","Z88.2","Z79.899","K62.5","Z12.11","M79.604","M79.89","J44.9","K21.9","E66.9","Z88.1","R09.1","R07.89","K62.1","K64.1","F41.9","J98.4","Z78.9","R60.9","L02.214","R60.0","S39.012A","S29.012A","M77.10","S46.911A","R03.0","L29.9","R06.02","R07.2","R94.31","M25.562","R91.1","F32.9","F43.29","J30.89","I10."],"date":["2020-03-11","2020-03-11","2020-03-11","2020-03-11","2021-01-25","2021-01-25","2021-10-13","2021-10-13","2021-10-13","2021-10-13","2021-10-13","2021-08-27","2021-08-27","2021-09-02","2020-05-04","2020-05-04","2021-09-01","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2021-03-03","2021-06-28","2020-05-04","2020-05-04","2021-05-05","2021-05-05","2021-05-05","2021-07-15","2020-08-03","2021-09-02","2021-11-08","2021-11-08","2021-12-16","2021-12-16","2019-03-14","2019-03-14","2019-05-24","2019-06-06","2019-05-24","2019-06-26","2019-12-11","2019-05-02","2019-05-02","2019-05-02","2019-03-14"],"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":[["","","ALBUTEROL","AER HFA","","Select","Select",""],["","","BUSPIRONE","TAB 15MG","","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","10","Select","Select",""],["","68180032006","BUPROPN","TAB 300MG XL","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","13668008130","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","00173086910","ANORO","AER 62.5-25","60","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","57664050389","TIZANIDINE","TAB 4MG","20","Select","Select",""],["","","CYCLOBENZAPR","TAB 5MG","","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","61442010360","DICLOFENAC","TAB 75MG DR","30","Select","Select",""],["","00172409660","BACLOFEN","TAB 10MG","20","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","00228202910","ALPRAZOLAM","TAB 0.5MG","15","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","","FUROSEMIDE","TAB 20MG","","Select","Select",""],["","","GAVILYTE-N","SOL FLAV PK","","Select","Select",""],["","08373982700","OPTICHAMBER","MIS DIA LG","1","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":""}]}]}