{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHRISTINE   M MANGONE","gend":1,"add":"APT D32 PO BOX 164","city":"CRAIGSVILLE","state":"VA","zip":"24430-9998","dob":"1965-02-19","age":"","mstatus":"","insh":"20056983*01","cliId":"","pno":"540\/480-4915","cno":"540\/480-4915","email":"","ename":"","eno":"","pphy":"LANDAUER, DIANE H MD","ppno":"540\/885-6789","pcpadd":"42 LAMBERT ST STE 111","pcpcity":"STAUNTON","pcpstate":"VA","pcpzip":24401,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/886-7364","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J44.9","R91.8","D68.51","M14.88","F17.210","M06.89","R63.4","R00.1","R94.31","M65.4","G56.03","J45.909","F32.9","Z20.822","R06.02","M47.819","M25.50","NO DATA","G89.29","Z79.899","Z79.52","Z72.820","R05.9","R07.9","Z51.81","R07.89","R10.11","R22.41","R10.9","M79.7","K12.1","J43.9","J00.","Z28.21","J01.41","K14.6","D10.1","J34.2","M54.2","R53.81","M06.9","Z15.89","F41.9","Z79.01","D64.9","R53.83","M62.838","J18.9","R09.1","R07.1","M15.9","R10.12","M54.6","W19.XXXA","S20.212A","J34.89","M53.86","M54.5","M54.16","M54.12","M43.10","Z20.828","J22.","R53.1","R42.","Z86.718","Z88.2","Z88.8","M54.9","M47.817","M25.511","Z03.818","R51.9","J30.2","D10.30","G56.01","S29.9XXA","R07.81","R00.2","J32.9","R06.00","M79.621"],"date":["2022-08-23","2021-10-14","2022-08-23","2021-10-18","2021-10-14","2021-10-14","2020-08-21","2021-02-08","2021-02-08","2021-04-14","2021-04-14","2021-09-18","2022-05-10","2021-09-18","2021-09-18","2022-05-10","2022-06-14","2022-08-23","2022-06-14","2022-05-10","2022-05-10","2022-05-10","2022-05-10","2022-09-02","2021-10-18","2022-09-02","2022-09-02","2022-09-02","2020-06-02","2021-10-18","2020-06-09","2021-10-14","2020-10-28","2020-10-28","2022-04-06","2022-04-06","2022-04-06","2022-04-06","2022-08-23","2022-08-23","2022-08-23","2022-08-23","2022-08-23","2022-08-23","2022-08-23","2022-08-23","2022-08-23","2020-04-14","2021-05-21","2020-04-14","2021-06-22","2021-11-30","2021-11-30","2021-12-17","2021-12-17","2022-04-06","2022-06-14","2021-05-04","2021-10-18","2021-10-18","2021-10-18","2021-07-02","2021-07-02","2022-06-29","2021-09-18","2022-03-08","2021-09-18","2021-09-18","2022-06-29","2021-10-18","2022-09-02","2020-11-06","2020-11-06","2021-05-21","2021-05-26","2021-08-11","2021-12-11","2021-12-11","2021-02-08","2021-04-20","2021-09-18","2022-09-02"],"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":[["","69097068205","PREGABALIN","CAP 150MG","60","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","180","Select","Select",""],["","42806054701","VITAMIN","CAP 1.25MG","4","Select","Select",""],["","00093719801","FLUOXETINE","CAP 40MG","60","Select","Select",""],["","00591505210","PREDNISONE","TAB 5MG","60","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","120","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","20","Select","Select",""],["","64125012710","FOLIC","TAB 1MG","270","Select","Select",""],["","31722072250","LEVOFLOXACIN","TAB 500MG","10","Select","Select",""],["","00832105415","BACLOFEN","TAB 10MG","60","Select","Select",""],["","60505265301","TRAZODONE","TAB 50MG","30","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","49483060250","IBUPROFEN","TAB 400MG","20","Select","Select",""],["","00085113204","PROVENTIL","AER HFA","7","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","59651018201","METHOTREXATE","TAB 2.5MG","40","Select","Select",""],["","00173088710","TRELEGY","AER ELLIPTA","60","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","90","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","66993058697","FLUTIC\/SALME","AER 500\/50","60","Select","Select",""],["","00173069700","ADVAIR","AER 500\/50","60","Select","Select",""],["","60505082701","IPRATROPIUM","SPR 0.0006","15","Select","Select",""],["","45802010901","TRIAMCINOLON","AER 55MCG\/AC","17","Select","Select",""],["","58657067601","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","00955100310","ENOXAPARIN","INJ 30\/0.3ML","2","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","27808003502","HYDROCO\/APAP","TAB 5-325MG","8","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","00093216568","NALOXONE","SPR ","2","Select","Select",""],["","00173086910","ANORO","AER 62.5-25","60","Select","Select",""],["","00591544005","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","00378932132","WIXELA","AER 250\/50","60","Select","Select",""],["","00173088210","BREO","INH 200-25","60","Select","Select",""],["","00054414622","CLOTRIMAZOLE","TRO 10MG","50","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","12","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":""}]}]}