{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARCUS   J GOODS","gend":0,"add":"158 GRAYMONT PL","city":"DANVILLE","state":"VA","zip":"24541-9998","dob":"2004-07-15","age":"","mstatus":"","insh":"9578811*01","cliId":"","pno":"434\/548-4333","cno":"","email":"","ename":"","eno":"","pphy":"MADDEN, DANA CATHERINE NP","ppno":"434\/924-5161","pcpadd":"1215 LEE ST FL 3","pcpcity":"CHARLOTTESVILLE","pcpstate":"VA","pcpzip":22903,"pcpcounty":"","pcpid":"","pcpname":"UNIVERSITY OF VIRGINIA PHYSICIANS GROUP","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/924-5559","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F32.9","F41.1","F94.0","F90.0","F81.9","Z73.4","E66.9","G43.909","G47.9","R06.83","Z68.54","L70.0","L20.89","Z91.010","J30.1","J45.30","T78.40XA","L29.9","Z00.129","Z23.","E55.9","B07.0","Z86.59","Z55.9","R41.840","F88.","F90.2","F33.1","F80.1","F33.3","L02.91","G47.8","L98.8","M79.18","L02.31","R79.82","D72.829","L05.01","T78.00XA","Z20.822","R45.86","F41.9","G47.21","R63.5","G47.10","F51.12","G47.30","G47.09","J30.2","L02.216","L02.415","R11.2","J45.909","G43.119","G47.00","F90.1","F80.89","F41.8","L02.215","L29.8","L03.115","S69.91XA","K58.0","K59.01","F91.3","J30.81","Z91.09","Z71.89","M79.605","S71.101A","R51.","K58.2","E88.81","R15.2"],"date":["2021-03-20","2021-12-31","2021-12-31","2021-10-21","2021-10-21","2021-10-21","2019-09-05","2019-07-05","2021-10-21","2019-07-05","2020-12-04","2019-07-19","2019-07-19","2019-09-16","2019-09-16","2019-09-16","2019-10-17","2019-10-17","2020-12-04","2020-12-04","2020-12-04","2020-12-04","2020-12-04","2020-12-04","2021-02-24","2021-10-21","2021-02-24","2021-05-12","2021-06-24","2021-12-31","2019-09-05","2020-06-01","2021-06-30","2021-06-30","2021-07-09","2021-07-09","2021-07-09","2021-07-14","2019-10-17","2021-09-10","2021-10-21","2020-06-08","2019-04-01","2020-03-05","2019-04-01","2019-04-01","2019-04-01","2019-04-01","2019-04-01","2019-09-05","2019-09-10","2021-07-02","2021-07-02","2019-01-14","2019-01-10","2019-03-05","2019-03-05","2019-03-05","2019-09-10","2019-06-07","2019-09-10","2021-03-30","2021-10-27","2021-10-27","2019-02-19","2019-06-11","2019-06-11","2019-06-11","2019-08-20","2019-09-23","2020-01-07","2020-03-05","2020-03-05","2020-03-05"],"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":[["","","TOPIRAMATE"," TOPIRAMATE ","60","Select","Select",""],["","","MELOXICAM"," MELOXICAM ","30","Select","Select",""],["","","DEXMETHYLPHE"," DEXMETHYLPHE ","30","Select","Select",""],["","","CITALOPRAM"," CITALOPRAM ","30","Select","Select",""],["","","FOCALIN"," FOCALIN ","30","Select","Select",""],["","","BUPROPION"," BUPROPION ","30","Select","Select",""],["","","QVAR"," QVAR ","11","Select","Select",""],["","","RETIN-A"," RETIN-A ","20","Select","Select",""],["","","TRETINOIN"," TRETINOIN ","45","Select","Select",""],["","","CIPROFLOXACN"," CIPROFLOXACN ","14","Select","Select",""],["","","CLINDAMYCIN"," CLINDAMYCIN ","60","Select","Select",""],["","","TRIAMCINOLON"," TRIAMCINOLON ","454","Select","Select",""],["","","FLOVENT"," FLOVENT ","11","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","10","Select","Select",""],["","","METRONIDAZOL"," METRONIDAZOL ","21","Select","Select",""],["","","EPINEPHRINE"," EPINEPHRINE ","2","Select","Select",""],["","","LEVOCETIRIZI"," LEVOCETIRIZI ","30","Select","Select",""],["","","MONTELUKAST"," MONTELUKAST ","90","Select","Select",""],["","","LATUDA","TAB 20MG","","Select","Select",""],["","","CYPROHEPTAD","TAB 4MG","","Select","Select",""],["","","DICYCLOMINE","TAB 20MG","","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":""}]}]}