{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PATSY   D LAM","gend":1,"add":"649 OAK HILL CT","city":"CHARLOTTESVILLE","state":"VA","zip":"22902-9998","dob":"1960-05-24","age":"","mstatus":"","insh":"20030835*01","cliId":"","pno":"434\/293-2265","cno":"434\/202-9093","email":"","ename":"","eno":"","pphy":"SCOTT, EVELYN S MD","ppno":"434\/924-1931","pcpadd":"1222 JEFFERSON PARK AVE 3RD FLOOR","pcpcity":"CHARLOTTESVILLE","pcpstate":"VA","pcpzip":22903,"pcpcounty":"","pcpid":"","pcpname":"UNIVERSITY OF VIRGINIA PHYSICIANS GROUP","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/924-1138","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.65","R07.89","E78.5","R53.83","R53.1","Z79.4","Z87.891","R13.10","E11.9","Z23.","E11.29","R80.9","R35.0","F17.200","Z86.010","H40.051","M65.311","G56.01","M65.319","R73.09","R07.9","N30.00","R10.9","F41.0","R31.29","N39.0","F32.9","K21.9","R05.","I10.","K62.5","B37.3","R10.33","NO DATA","K31.7","K44.9","R29.898","G60.9","E66.9","H52.03","H52.203","H52.4","Z79.84","R09.89","R10.819","F32.1","K52.9","F32.2","R41.3","R11.0","N20.0","R10.32","R19.7","R10.13","G89.29","R10.84","L30.8"],"date":["2021-11-17","2020-04-12","2020-04-12","2020-04-12","2020-04-12","2021-05-19","2021-05-19","2021-10-20","2021-05-19","2021-09-30","2021-05-19","2021-05-19","2021-11-23","2021-11-17","2020-02-05","2021-02-10","2021-02-22","2021-02-22","2021-02-22","2021-02-22","2021-05-01","2021-09-28","2021-09-28","2021-10-05","2021-11-23","2021-11-23","2020-06-30","2020-06-30","2020-01-29","2020-01-29","2020-01-29","2021-02-17","2021-09-30","2021-10-20","2021-10-20","2021-10-20","2020-06-30","2020-06-30","2020-06-30","2021-01-07","2021-01-07","2021-01-07","2021-01-11","2021-09-14","2021-09-28","2019-11-13","2019-11-13","2019-11-13","2019-09-18","2019-09-18","2019-09-18","2019-09-18","2019-09-18","2019-08-19","2019-08-19","2019-04-24","2019-04-24"],"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":[["","55111015810","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","53885044801","ONETOUCH","KIT ULTRA 2","1","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","","PHENAZOPYRID","TAB 100MG","","Select","Select",""],["","13668001005","CITALOPRAM","TAB 20MG","30","Select","Select",""],["","60505014201","GLIPIZIDE","TAB 10MG","60","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","","MECLIZINE","TAB 12.5MG","","Select","Select",""],["","","LANTUS","INJ 100\/ML","","Select","Select",""],["","08290320122","BD  PEN NEEDL","MIS 32GX4MM","100","Select","Select",""],["","70377000415","SIMVASTATIN","TAB 40MG","30","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","59267100003","PFIZER","INJ COVID-19","0","Select","Select",""],["","43199001301","HYOSCYAMINE","TAB 0.125MG","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","42806016005","HYDROXYZ","TAB 25MG","30","Select","Select",""],["","51672128902","NYSTATIN","CRE 100000","30","Select","Select",""],["","","MUCINEX","TAB 600MG ER","","Select","Select",""],["","","ONE","KIT VERIO FL","","Select","Select",""],["","","CIPROFLOXACN","TAB 250MG","","Select","Select",""],["","50458014030","INVOKANA","TAB 100MG","30","Select","Select",""],["","","BENZONATATE","CAP 100MG","","Select","Select",""],["","","CVS","TAB 600MG","","Select","Select",""],["","65702043810","ACCU-CHEK","TES AVIVA PL","50","Select","Select",""],["","","BASAGLAR","INJ 100UNIT","","Select","Select",""],["","08317880128","TECHLITE","MIS LANCETS","100","Select","Select",""],["","00193725201","CONTOUR","KIT NEXT EZ","1","Select","Select",""],["","99073070914","FREESTYLE    KIT FREEDOM","KIT FREEDOM","1","Select","Select",""],["","00002143380","TRULICITY","INJ 0.75\/0.5","2","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","00093081101","NORTRIPTYLIN","CAP 25MG","30","Select","Select",""],["","00169406012","VICTOZA","INJ 18MG\/3ML","6","Select","Select",""],["","00310653004","BYDUREON","INJ 2MG","4","Select","Select",""],["","00093031101","LOPERAMIDE","CAP 2MG","30","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":""}]}]}