{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"APRIL TILLMAN","gend":1,"add":"PO BOX 911","city":"CHARLOTTESVILLE","state":"VA","zip":"22902-9998","dob":"1980-01-14","age":"","mstatus":"","insh":"20058726*01","cliId":"","pno":"434\/962-7209","cno":"","email":"","ename":"","eno":"","pphy":"SCHECTMAN, JOEL M MD","ppno":"434\/924-1931","pcpadd":"1222 JEFFERSON PARK AVE","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\/243-5906","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.2","M54.12","Z86.79","I42.9","M53.3","F10.20","R10.13","K58.9","K92.1","I51.81","Z72.0","I10.","NO DATA","Z87.898","F12.90","Z91.5","Z90.710","R42.","M54.5","M54.16","G89.4","Z23.","R10.2","R11.0","F41.9","M48.02","M46.82","M50.321","M50.322","M51.37","M53.83","M54.17","R52.","F32.9","Z20.822","F19.11","M79.2","N76.0","M25.511","M47.812","M54.9","M54.2","G56.02","F41.1","F17.210","N89.8","H65.499","N92.1","N73.6","N80.1","F17.200","J30.2","G89.29","R94.31","K59.00","R82.90","R21.","F33.9","M47.816","B37.3","B35.3","J06.9","M47.892","M51.36","G56.01"],"date":["2020-07-28","2020-02-18","2021-07-20","2020-07-16","2020-06-26","2020-09-24","2021-08-10","2021-08-10","2021-08-10","2020-01-22","2021-07-20","2021-12-20","2021-12-20","2020-07-16","2021-07-20","2021-07-20","2021-12-20","2020-01-15","2020-06-05","2020-06-05","2020-06-05","2021-12-20","2021-12-20","2021-12-20","2021-12-20","2020-01-22","2020-01-22","2020-01-22","2020-01-22","2020-01-22","2020-01-22","2020-01-22","2020-06-08","2021-07-20","2021-12-03","2021-07-20","2020-06-05","2021-06-11","2020-01-13","2020-01-13","2019-11-01","2019-09-23","2019-07-09","2019-09-03","2019-08-29","2019-08-29","2019-08-29","2019-10-15","2019-10-15","2019-10-15","2019-11-01","2019-11-01","2019-11-01","2019-06-19","2019-07-12","2019-07-12","2019-07-22","2019-07-22","2019-07-22","2019-07-22","2019-07-22","2019-11-05","2019-06-12","2019-06-12","2019-06-04"],"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":[["","50111064803","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","","BUSPIRONE","TAB 10MG","","Select","Select",""],["","00904506860","MI-ACID","CHW 80MG","30","Select","Select",""],["","00527058610","DICYCLOMINE","CAP 10MG","30","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","00527260043","METOPROL","TAB 25MG ER","30","Select","Select",""],["","00046087221","PREMARIN","CRE 0.625MG","30","Select","Select",""],["","57896048914","POLYETH","POW 3350 NF","238","Select","Select",""],["","65862020199","LOSARTAN","TAB 25MG","90","Select","Select",""],["","57237007530","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","00172572880","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","","SENNA","TAB 8.6MG","","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","","BISACODYL","SUP 10MG","","Select","Select",""],["","","IVAREST","CRE IVY ITCH","","Select","Select",""],["","","GERI-KOT","TAB 8.6MG","","Select","Select",""],["","00904671980","ACETAMINOPHE","TAB 325MG","60","Select","Select",""],["","","GABAPENTIN","CAP 300MG","","Select","Select",""],["","00536344238","CEROVITE","TAB ADVANCED","30","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","","HYDROXYZ","TAB 25MG","","Select","Select",""],["","","AMITRIPTYLIN","TAB 10MG","","Select","Select",""],["","","CHLORTHALID","TAB 25MG","","Select","Select",""],["","","PEG3350","POW ","","Select","Select",""],["","","HYDROCORT","CRE 0.025","","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","00185111160","BUPROPION","TAB 200MG SR","60","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","30","Select","Select",""],["","67877057501","BENZONATATE","CAP 200MG","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":""}]}]}