{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KAREN   D JONES","gend":1,"add":"407 BROOKE DR APT 2","city":"DANVILLE","state":"VA","zip":"24540-9998","dob":"1966-11-16","age":"","mstatus":"","insh":"20043596*01","cliId":"","pno":"434\/446-8116","cno":"434\/228-0146","email":"","ename":"","eno":"","pphy":"LE, UYEN MD","ppno":"434\/572-8921","pcpadd":"1020 BILL TUCK HWY STE 900","pcpcity":"SOUTH BOSTON","pcpstate":"VA","pcpzip":24592,"pcpcounty":"","pcpid":"","pcpname":"FULLER ROBERTS OBGYN & PRIMARY CARE","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/575-1290","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J06.9","Z01.812","Z01.818","K82.8","Z20.828","Z28.21","F41.1","R05.","K21.9","E66.01","K58.1","R10.9","Z90.49","Z86.010","F17.200","H10.32","Z11.52","R51.9","I10.","E11.9","E78.5","N95.0","J45.20","J11.1","H81.399","R10.11","R14.0","R11.0","K76.0","M25.561","R10.84","R19.4","K30.","R19.7","M25.531","R68.81","K58.9","R21."],"date":["2021-08-30","2020-10-02","2020-10-02","2020-10-06","2021-08-05","2020-10-20","2021-03-01","2021-07-30","2021-04-02","2020-09-16","2021-04-02","2021-04-02","2021-04-02","2021-04-02","2021-04-02","2021-09-02","2021-09-02","2021-07-21","2021-07-21","2021-07-21","2021-07-21","2021-09-20","2020-07-30","2019-12-05","2019-09-30","2019-11-01","2019-11-01","2019-10-21","2019-11-01","2019-01-29","2019-02-15","2019-02-15","2019-02-15","2019-02-15","2019-06-28","2019-11-01","2019-01-25","2019-03-12"],"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":[["","43199001301","HYOSCYAMINE","TAB 0.125MG","120","Select","Select",""],["","64764024060","AMITIZA","CAP 24MCG","30","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","60","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","51991077290","LANSOPRAZOLE","CAP 30MG DR","30","Select","Select",""],["","00456120230","LINZESS","CAP 290MCG","90","Select","Select",""],["","65862067899","ALPRAZOLAM","TAB 1MG","30","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","120","Select","Select",""],["","50428847260","CVS","TAB 180MG","90","Select","Select",""],["","68382076010","METFORMIN","TAB 1000MG","30","Select","Select",""],["","53885000810","ONETOUCH","MIS PLUS 33G","100","Select","Select",""],["","65162044210","MECLIZINE","TAB 25MG","30","Select","Select",""],["","70377002711","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","10702025350","BUT\/APAP\/CAF","TAB ","15","Select","Select",""],["","50428047857","EYE","DRO 0.025%OP","5","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","66685100200","AMOX\/K","TAB 500-125","20","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","240","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","30","Select","Select",""],["","45802057178","FEXOFENADINE","TAB 180MG","90","Select","Select",""],["","68180051201","LISINOPRIL","TAB 2.5MG","30","Select","Select",""],["","64380080307","RANITIDINE","TAB 150MG","60","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","00004080085","TAMIFLU","CAP 75MG","10","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","28","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","12","Select","Select",""],["","00054001729","PREDNISONE","TAB 10MG","10","Select","Select",""],["","68462079817","TRIAMCINOLON","OIN 0.005","15","Select","Select",""],["","58657050016","CODEINE\/GG","SOL 10-100\/5","240","Select","Select",""],["","59779017662","ALLERGY-D","TAB 5-120MG","15","Select","Select",""],["","70710101002","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","50428033768","CLD\/FLU\/SORE","LIQ THROAT","177","Select","Select",""],["","50580072812","ZYRTEC-D","TAB 5-120MG","10","Select","Select",""],["","10702001150","HYDROXYZ","TAB 25MG","30","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","100","Select","Select",""],["","49884093547","DICLOFENAC","GEL 0.01","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":""}]}]}