{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANNETTE  M MCCARTHY","gend":1,"add":"PO BOX 809","city":"HARRISONBURG","state":"VA","zip":22803,"dob":"1962-08-07","age":"","mstatus":"","insh":"20052450*01","cliId":"","pno":"540\/430-1562","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"540\/248-3413","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":22803,"pcpcounty":"","pcpid":"","pcpname":"Carilion Family Medicine - Dayton","plan":"OHP","program":"Medicaid","lob":"OHCC","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/248-8413","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["B18.2","L40.9","Z51.81","G25.9","F14.94","F14.951","G47.00","E11.9","I10.","F17.200","Z79.4","Z91.041","Z88.8","Z53.20","L29.9","M79.671","M79.672","M25.551","S22.080A","E11.3393","H25.13","R51.","R11.2","E11.65","F14.10","NO DATA","F14.20","R06.00","S22.49XA","F19.94","F19.951","S22.41XA","N39.0","R55.","S79.911A","F14.24","F41.9","E11.42","M70.61","S33.9XXA","M25.552","J20.9","R23.4","R21.","L40.50","Z79.899","Z79.52","Z20.822","E03.9","E78.00","D50.9","R63.4","L53.8","B86.","N10.","L30.8","L40.0","Z88.1","Z87.2","L84.","R76.8","Z79.1","Z90.49","Z82.49","Z83.3","Z82.3","M54.41","G89.29","Z86.19","R47.81","I99.9","F14.988","Z79.890","Z88.6","R10.30","K57.31","F12.10","I16.0","F15.90","F17.210","K64.8","Z53.9","Z78.9","D62.","G43.809","R35.0","M54.30","M54.42","L30.9","F14.90","L53.9","K92.2","K62.5","K29.60","K31.89","S50.812A","S50.811A","K57.90","D64.9"],"date":["2022-10-12","2022-10-12","2022-05-20","2020-01-13","2020-01-20","2020-01-20","2020-01-23","2022-09-22","2022-10-12","2022-10-12","2022-10-12","2022-09-22","2022-09-22","2020-02-12","2022-06-26","2020-07-21","2020-07-21","2020-10-23","2020-10-23","2020-06-10","2020-06-10","2020-09-22","2022-05-19","2022-10-12","2022-10-12","2022-10-12","2020-01-23","2020-01-17","2020-01-17","2020-01-23","2020-01-23","2020-01-12","2020-01-12","2020-01-12","2020-10-24","2020-01-13","2022-08-28","2020-07-21","2020-10-07","2020-10-07","2020-10-07","2019-01-01","2022-03-14","2022-09-22","2022-05-25","2022-09-22","2022-09-22","2022-03-31","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-08-09","2022-06-04","2022-08-28","2022-06-09","2022-06-26","2022-08-28","2022-02-20","2022-03-14","2022-05-20","2022-09-22","2022-06-09","2022-06-12","2022-06-04","2022-06-04","2022-05-26","2022-05-26","2022-06-12","2022-05-25","2022-05-29","2022-05-29","2022-09-22","2022-08-28","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-13","2022-05-19","2022-05-19","2022-05-19","2022-05-26","2022-05-29","2022-06-13","2022-06-13","2022-10-12","2022-10-13","2022-10-12","2022-10-12","2022-09-22","2022-09-22","2022-10-12","2022-10-13"],"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":[["","","HUMIRA","KIT 40MG\/0.8","","Select","Select",""],["","69238153206","CLOBETASOL","CRE 0.0005","120","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","16714008310","HYDROXYZ","TAB 50MG","20","Select","Select",""],["","00472024260","PERMETHRIN","CRE 0.05","60","Select","Select",""],["","65162018810","NAPROXEN","TAB 250MG","14","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","16714020030","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","","PREDNISONE","TAB 20MG","","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","6","Select","Select",""],["","00172392670","DIAZEPAM","TAB 5MG","1","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","00002871501","HUMULIN","INJ 70\/30","10","Select","Select",""],["","81131013834","INSULIN","MIS 1ML\/31G","30","Select","Select",""],["","","ATORVASTATIN","TAB 20MG","","Select","Select",""],["","","LEVOTHYROXIN","TAB 50MCG","","Select","Select",""],["","68645051054","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","31722070190","LOSARTAN","TAB 50MG","30","Select","Select",""],["","00169183702","NOVOLIN70\/30","INJ RELION","10","Select","Select",""],["","43598044828","NICOTINE","DIS 21MG\/24H","28","Select","Select",""],["","00169183711","NOVOLIN","INJ 70\/30","10","Select","Select",""],["","46287050630","SIMETHICONE","DRO 40\/0.6ML","30","Select","Select",""],["","68645051554","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","00046087221","PREMARIN","CRE 0.625MG","30","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","","OMEPRAZOLE","CAP 20MG DR","","Select","Select",""],["","","TRAMADOL","TAB 50MG","","Select","Select",""],["","00088222033","LANTUS","INJ 100\/ML","10","Select","Select",""],["","10370010250","BUPROPN","TAB 300MG XL","30","Select","Select",""],["","","QUETIAPINE","TAB 300MG","","Select","Select",""],["","","DIVALPROEX","TAB 250MG DR","","Select","Select",""],["","","ISONIAZID","TAB 300MG","","Select","Select",""],["","","LIDOCAINE","PAD 0.05","","Select","Select",""],["","69238110005","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","31604004080","MELATONIN","TAB 3MG","60","Select","Select",""],["","16729016917","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","00002751001","HUMALOG","INJ 100\/ML","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":[]}},{"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":""}]}]}