{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" YHTAKSBBIG","gend":1,"add":"EGDE 606RD DOOW","city":"DANVILLE","state":"VA","zip":"24541-9998","dob":"1960-06-06","age":"","mstatus":"","insh":"8432210*98","cliId":"","pno":"17\/4346693-0","cno":"434\/710-3966","email":"","ename":"","eno":"","pphy":"BEATTY, GARRETT DO","ppno":"434\/799-4488","pcpadd":"SUITE 201 109 BRIDGE STREET","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D05.12","J30.2","E53.8","I10.","G61.0","M10.9","R06.00","K59.09","E55.9","K21.9","L20.9","G63.","R69.","D48.1","J20.9","U09.9","J30.9","C90.30","C79.81","E88.09","D47.3","R18.0","D51.9","J45.998","D05.10","F32.9","K64.0","Z85.41","H52.7","H04.129","D47.2","R60.0","Z91.89","G62.89","M79.672","C90.20","Z92.3","Z79.899","R01.1","G61.81","R26.1","Z85.3","K82.8","R06.09","R60.9","G47.33","R13.10","R10.9","K31.89","M79.662","M79.661","M79.641","G47.30","R26.2","L57.8","L57.0","Z12.83","Z85.820","L81.4","D18.01","L82.1","D23.5","D22.71","D22.72","U07.1","E86.0","F06.31","R05.9","R00.0","G47.34","E66.9","Z91.81","C50.212","Z79.811","Z17.0","D22.9","D23.9","D23.39","L28.0","D22.5","G60.9","D49.0","K43.9","R05.3","J45.909","E61.1","R79.89","R18.8","C72.9","G90.09","G62.9","Z76.82","R74.0","R26.9","R53.1","Z51.11","L98.9","R10.84","I88.0","R19.7","K80.20","E66.01","Z68.41","R10.11","K59.00","E34.9","Z86.010","K29.70","NO DATA","M25.562","R10.30","K64.9","K63.89","R12.","R09.81","J42.","R41.3","S09.90XA","W01.198A","J30.89","J34.2","J34.3","Z86.16","Z68.38","H04.123","L28.1","D22.61","D22.62","Z68.39","R55.","Z01.812","Z20.822","Z90.89","R21.","B07.8","L21.9","M79.642","Z20.828","V58.89","L91.8","C43.62","L71.1","D23.72","S70.362A","W57.XXXA","M25.572","M77.50","K63.5","R93.3","R76.8","S93.492A","W18.30XA","R14.0","Z09.","R63.5","I07.1","K22.2","H93.12","R44.9","E65.","T66.XXXS","K80.21","R52.","W19.XXXA","Z48.02","E83.52"],"date":["2022-06-23","2022-09-12","2022-06-23","2022-08-15","2022-06-23","2022-06-23","2022-06-23","2022-06-23","2022-06-23","2022-07-10","2022-06-23","2022-06-23","2022-10-17","2022-08-03","2022-08-17","2022-08-05","2022-09-08","2022-01-14","2022-03-26","2022-05-31","2020-04-01","2020-04-01","2020-04-01","2020-04-01","2022-01-14","2020-04-01","2020-04-01","2020-04-01","2021-03-30","2021-03-30","2022-09-12","2022-04-20","2020-11-24","2021-06-02","2021-07-06","2022-02-25","2021-02-22","2022-08-03","2021-07-08","2022-02-17","2021-06-02","2022-07-10","2021-07-22","2021-06-05","2021-12-21","2022-09-12","2022-03-14","2021-08-19","2022-01-27","2021-11-03","2021-11-03","2021-11-03","2021-09-19","2022-02-17","2022-05-25","2022-05-25","2022-05-25","2022-05-25","2022-05-25","2022-05-25","2022-05-25","2022-05-25","2022-05-25","2022-05-25","2022-07-03","2022-07-03","2022-01-25","2022-07-28","2021-11-24","2021-11-29","2022-04-29","2021-11-29","2022-05-31","2022-05-31","2022-05-31","2022-02-16","2022-02-16","2022-02-16","2022-02-16","2022-02-16","2022-03-30","2022-04-28","2022-08-01","2022-09-12","2022-04-29","2022-02-25","2022-04-20","2021-07-08","2020-01-01","2020-01-01","2021-10-20","2020-09-16","2020-05-15","2020-07-09","2022-07-10","2020-09-16","2020-09-16","2021-03-08","2021-03-08","2021-03-08","2021-04-15","2022-06-02","2021-08-04","2022-01-27","2022-03-14","2022-03-14","2022-03-14","2022-03-14","2021-12-21","2021-12-21","2022-03-14","2022-03-14","2022-03-14","2022-01-27","2022-04-13","2022-04-13","2022-04-13","2022-07-03","2022-07-03","2022-09-12","2022-06-24","2022-06-24","2022-07-28","2022-07-28","2020-06-26","2021-11-17","2021-11-17","2021-11-17","2022-01-27","2022-07-10","2021-06-03","2021-08-26","2021-07-06","2021-07-06","2021-08-25","2021-08-25","2021-10-12","2021-11-15","2020-08-13","2020-09-18","2020-11-20","2020-09-18","2020-09-18","2020-09-18","2020-09-18","2021-02-04","2021-02-04","2021-08-30","2021-03-29","2020-05-15","2020-08-10","2020-08-10","2021-03-08","2021-03-18","2021-03-18","2021-06-04","2021-08-19","2021-12-20","2021-12-20","2021-04-27","2021-07-08","2021-06-28","2020-08-10","2020-08-10","2020-11-20","2021-02-03"],"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":[["","00536123441","ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","96295011343","VITAMIN","TAB 500MCG","90","Select","Select",""],["","41167432007","ALLEGRA-D","TAB 24 HOUR","30","Select","Select",""],["","63824005634","MUCINEX","TAB 30-600ER","30","Select","Select",""],["","70069000510","CYANOCOBALAM","INJ 1000MCG","1","Select","Select",""],["","35515095912","QC","TAB 500MCG","90","Select","Select",""],["","00591544310","PREDNISONE","TAB 20MG","7","Select","Select",""],["","51224000160","BENZONATATE","CAP 200MG","90","Select","Select",""],["","41167580005","NASACORT","SPR 55MCG\/AC","17","Select","Select",""],["","40093010116","D3","CAP 2000UNIT","30","Select","Select",""],["","00093598627","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","45802042578","FEXOFENADINE","TAB 60MG","60","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","45","Select","Select",""],["","51991075933","LETROZOLE","TAB 2.5MG","30","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","30","Select","Select",""],["","16729013516","ALLOPURINOL","TAB 300MG","30","Select","Select",""],["","69315011610","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","71093012105","GABAPENTIN","CAP 300MG","60","Select","Select",""],["","63868000230","NATURA-LAX","POW 3350 NF","510","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","31722053001","TORSEMIDE","TAB 10MG","30","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","10","Select","Select",""],["","57896022110","ACETAMIN","TAB 500MG","30","Select","Select",""],["","51991096257","POLYETH","POW 3350 NF","510","Select","Select",""],["","60432052805","SELENIUM","LOT 0.025","118","Select","Select",""],["","24385011778","GNP","TAB 500MCG","90","Select","Select",""],["","63868085556","TUSSIN","SYP 100-10\/5","118","Select","Select",""],["","00113030603","CLEARLAX","POW ","510","Select","Select",""],["","68382079101","ACYCLOVIR","TAB 400MG","20","Select","Select",""],["","43547039711","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","55111068405","IBU","TAB 800MG","12","Select","Select",""],["","00406048401","APAP\/CODEINE","TAB 300-30MG","20","Select","Select",""],["","00054418325","DEXAMETHASON","TAB 2MG","12","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","27808003503","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","68462035594","DICLOFENAC","GEL 0.03","100","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":""}]}]}