{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TRACY MCCAULEY","gend":1,"add":"271 DENNIS LN","city":"BREMO BLUFF","state":"VA","zip":23022,"dob":"1975-05-15","age":"","mstatus":"","insh":"20031754*01","cliId":"","pno":"434\/270-3079","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"434\/243-9466","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23022,"pcpcounty":"","pcpid":"","pcpname":"UNIVERSITY OF VIRGINIA PHYSICIANS GROUP","plan":"OHP","program":"Medicaid","lob":"OHCC","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/243-9499","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.69","E78.1","E55.9","K86.9","M54.5","G89.29","Z12.4","E11.9","H43.392","H52.4","M54.16","M51.36","N39.0","K85.90","K86.1","N30.01","R10.11","R39.9","K83.1","Z01.818","Z00.00","Z12.31","Z12.11","H61.21","R10.84","M47.816","M53.3","R10.9","NO DATA","R11.2","E10.9","A04.8","D72.829","R35.0","Z12.39","F41.9","M25.551","K52.9","N30.00","K22.10","K29.50","R79.89","B96.81","K26.9","J44.9","F17.200","Z86.010","M79.601","K86.81","K76.0","R19.7","F17.210","Z79.4","M54.9","Z79.51","Z79.899","Z88.5","Z88.0","Z88.2","Z88.8","Z83.3","E13.9","B37.3","R30.0","N12.","R31.21","N90.5","R10.31","R11.15","E11.65","Z98.890","Z72.0","E66.9","R10.13","K29.70","E83.39","Z20.822","K59.09","Z68.32","Z90.81","S36.209S","R74.8","Z90.49","Z87.59","Z46.59","R11.0","Z13.31","N89.8","L60.0","B35.1","D23.71"],"date":["2022-07-06","2022-07-06","2021-08-09","2022-07-06","2021-08-09","2022-02-09","2019-11-05","2022-09-09","2019-11-19","2019-11-19","2019-11-19","2019-11-19","2020-07-27","2021-05-28","2022-10-26","2021-01-27","2021-05-09","2021-01-27","2022-09-09","2021-11-30","2021-01-04","2021-01-04","2021-01-04","2021-02-26","2021-03-15","2021-03-15","2021-03-15","2022-02-09","2022-02-09","2021-04-26","2021-12-03","2021-05-05","2021-05-05","2019-08-30","2019-10-09","2019-12-12","2019-12-20","2022-03-08","2021-02-26","2021-04-28","2021-04-28","2021-04-28","2021-04-28","2021-05-28","2021-12-03","2021-12-03","2021-04-16","2019-03-13","2020-10-29","2022-09-29","2020-09-21","2022-09-09","2022-09-09","2020-10-29","2020-10-29","2022-09-09","2022-09-09","2020-10-29","2022-09-09","2022-09-09","2020-10-29","2022-02-02","2019-01-09","2019-06-27","2019-06-27","2019-11-11","2019-11-11","2021-04-25","2020-07-27","2021-05-09","2021-05-09","2019-11-11","2022-07-06","2021-04-23","2021-04-25","2021-04-25","2022-09-09","2021-04-25","2021-04-25","2021-04-25","2022-02-02","2022-10-21","2022-09-09","2022-09-09","2022-06-15","2022-10-21","2022-02-09","2022-02-09","2022-08-29","2022-08-29","2022-08-29"],"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":[["","","DICLOFENAC"," DICLOFENAC ","60","Select","Select",""],["","","LANTUS"," LANTUS ","15","Select","Select",""],["","08528147401","TRUE","MIS ","1","Select","Select",""],["","","CREON"," CREON ","540","Select","Select",""],["","","DICYCLOMINE"," DICYCLOMINE ","30","Select","Select",""],["","62175030232","RABEPRAZOLE","TAB 20MG","30","Select","Select",""],["","","FLUCONAZOLE"," FLUCONAZOLE ","2","Select","Select",""],["","","8","TAB 650MG","","Select","Select",""],["","","APIDRA"," APIDRA ","15","Select","Select",""],["","","VITAMIN"," VITAMIN ","126","Select","Select",""],["","08290320122","BD  PEN NEEDL","MIS 32GX4MM","200","Select","Select",""],["","","BACLOFEN"," BACLOFEN ","90","Select","Select",""],["","","CYCLOBENZAPR"," CYCLOBENZAPR ","60","Select","Select",""],["","55111068405","IBU","TAB 800MG","20","Select","Select",""],["","","ALBUTEROL","NEB 0.00083","","Select","Select",""],["","","PROMETHAZINE","TAB 25MG","","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","40","Select","Select",""],["","","ONETOUCH"," ONETOUCH ","300","Select","Select",""],["","65702040810","ACCU-CHEK","TES AVIVA PL","100","Select","Select",""],["","53885004401","ONE","KIT VERIO FL","1","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","68001042300","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","","SURE","MIS 32GX5\/32","","Select","Select",""],["","","TRUPLUS","MIS 33G","","Select","Select",""],["","","OXYCODONE","TAB 5MG","","Select","Select",""],["","08222720031","GNP","MIS 32GX5\/32","120","Select","Select",""],["","52268010001","GOLYTELY","SOL ","4000","Select","Select",""],["","58914021460","AQUADEKS","DRO ","60","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","Select","Select",""],["","62756018388","OXCARBAZEPIN","TAB 150MG","120","Select","Select",""],["","65862001905","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","55111012705","CIPROFLOXACN","TAB 500MG","10","Select","Select",""],["","00406012310","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","68462039710","OMEPRAZOLE","CAP 40MG","60","Select","Select",""],["","00068042017","CITRUCEL","POW SF ORANG","479","Select","Select",""],["","51672400101","NORTRIPTYLIN","CAP 10MG","30","Select","Select",""],["","00781196260","CLARITHROMYC","TAB 500MG","20","Select","Select",""],["","13668001005","CITALOPRAM","TAB 20MG","30","Select","Select",""],["","50580078324","TYLENOL","TAB 650MG","60","Select","Select",""],["","46122006278","8HR","TAB 650MG","60","Select","Select",""],["","00046087221","PREMARIN","CRE 0.625MG","30","Select","Select",""],["","08222710031","PEN  NEEDLES","MIS 32GX4MM","100","Select","Select",""],["","","ARTHRTS","TAB 650MG","","Select","Select",""],["","63304044990","FENOFIBRATE","TAB 145MG","30","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","","VASCEPA","CAP 1GM","","Select","Select",""],["","","PRODIGY","TES CODING","","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":""}]}]}