{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TONYA   H CURRY","gend":1,"add":"316 SUMMIT ROAD","city":"DANVILLE","state":"VA","zip":"24540-9998","dob":"1974-08-10","age":"","mstatus":"","insh":"1444862*01","cliId":"","pno":"434\/835-4071","cno":"434\/835-4071","email":"","ename":"","eno":"","pphy":"SHIFFLETT, JEREMY PA","ppno":"434\/791-4793","pcpadd":"705 MAIN STREET","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/791-4048","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z09.","Z87.440","Z87.442","M54.5","Z30.42","H25.13","H35.30","N20.0","R53.1","N39.0","NO DATA","M51.36","M47.816","M54.16","U07.1","G43.019","F33.0","F41.1","G47.00","Z32.02","A41.9","N13.6","N17.9","K21.9","Z20.828","Z90.49","Z98.51","Z98.890","R10.9","R30.0","E11.9","H35.373","I10.","K57.32","Z88.2","Z20.822","R11.0","J30.1","R33.9","K57.90","J02.9","B96.89","F17.210","R35.0"],"date":["2020-12-10","2020-12-10","2020-12-10","2021-06-24","2020-06-17","2021-08-25","2020-07-01","2020-11-27","2021-07-05","2021-10-23","2022-02-28","2022-02-28","2022-02-28","2022-03-11","2022-01-11","2022-01-27","2022-01-27","2022-01-27","2022-01-27","2020-03-13","2020-11-26","2020-11-26","2020-11-26","2020-11-26","2020-11-26","2020-11-26","2020-11-26","2020-11-26","2020-11-26","2021-10-23","2021-08-25","2021-08-25","2021-10-25","2022-06-19","2022-06-19","2022-06-19","2022-06-19","2021-10-20","2022-06-19","2022-06-19","2022-01-11","2021-10-23","2021-10-23","2021-10-23"],"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":[["","29300022010","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","67457088701","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","00023650110","UBRELVY","TAB 100MG","20","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","00172409680","BACLOFEN","TAB 10MG","90","Select","Select",""],["","16729000417","SIMVASTATIN","TAB 10MG","30","Select","Select",""],["","65862069705","VENLAFAXINE","CAP 150MG ER","60","Select","Select",""],["","63824005632","MUCINEX","TAB 30-600ER","20","Select","Select",""],["","68462025501","ROPINIROLE","TAB 1MG","30","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","00006007861","JANUMET","TAB 50-500MG","30","Select","Select",""],["","68382041205","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","51224011960","GABAPENTIN","CAP 300MG","81","Select","Select",""],["","00591544243","PREDNISONE","PAK 10MG","48","Select","Select",""],["","29300011605","TOPIRAMATE","TAB 50MG","60","Select","Select",""],["","51759020410","AJOVY","INJ 225\/1.5","2","Select","Select",""],["","52817036000","METOPROL","TAB 25MG","60","Select","Select",""],["","00093117401","PENICILLN","TAB 500MG","40","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","80681012800","VITAMIN","TAB 500MCG","30","Select","Select",""],["","72578000701","METRONIDAZOL","TAB 250MG","21","Select","Select",""],["","50383077504","LIDOCAINE","SOL 2% VISC","150","Select","Select",""],["","00074709530","QULIPTA","TAB 10MG","30","Select","Select",""],["","00002143380","TRULICITY","INJ 0.75\/0.5","2","Select","Select",""],["","71930001752","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00093747243","RIZATRIPTAN","TAB 10MG","12","Select","Select",""],["","57896010410","ACETAMINOPHE","TAB 325MG","50","Select","Select",""],["","16729017501","AMITRIPTYLIN","TAB 100MG","15","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","47884017550","EASYMAX","TES ","100","Select","Select",""],["","56151014401","TRUPLUS","MIS 30G","100","Select","Select",""],["","56151014201","TRUEDRAW","MIS LANC DEV","1","Select","Select",""],["","74312013329","FISH","CAP 1200MG","30","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","20","Select","Select",""],["","49281042150","FLUZONE","INJ 2021-22","0","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","75826011510","PHENAZOPYRID","TAB 200MG","9","Select","Select",""],["","69097015912","MELOXICAM","TAB 15MG","30","Select","Select",""],["","00006011254","JANUVIA","TAB 50MG","30","Select","Select",""],["","64764017130","DEXILANT","CAP 30MG DR","30","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","10","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}