{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KAREN   R JONES","gend":1,"add":"30 LANDINGS LN APT 11","city":"WEYERS CAVE","state":"VA","zip":"24486-9998","dob":"1974-08-02","age":"","mstatus":"","insh":"20068093*01","cliId":"","pno":"804\/307-8276","cno":"804\/307-8276","email":"","ename":"","eno":"","pphy":"COULTER, CAROLINE DO","ppno":"540\/828-2634","pcpadd":"100 HEALTH CENTER DR","pcpcity":"BRIDGEWATER","pcpstate":"VA","pcpzip":22812,"pcpcounty":"","pcpid":"","pcpname":"Carilion Family Medicine - Bridgewater","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/828-6911","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R20.2","R42.","M43.12","Z98.1","M53.2X2","M54.12","G56.03","G56.20","M25.552","G56.13","R05.","R53.83","Z20.822","M54.16","M47.817","M17.12","Z79.899","K25.9","K26.9","R10.13","Z87.11","Z11.52","Z68.31","E66.9","Z47.1","M25.562","M25.662","R29.898","Z96.652","Z91.81","L70.0","L01.01","L20.84","L72.8","Z11.59","M51.36","V54.17","F90.0","F41.1","K29.80","K31.89","M18.11","M19.031","M54.5","F17.200","Z88.5","M79.605","G89.18","M51.16","M50.30","F41.9","F17.210","Z79.82","H40.013","Z72.0","M79.641","X50.0XXA","K29.60","M16.12","M71.22","G57.12","M54.2","M79.89","D72.829","Z87.891","J06.9","M54.17","M46.96","M13.80","R20.0","M53.1","R51.9","K58.1","K21.9","A04.9","Z87.19","R10.10","M46.1","M25.561","R10.2","M25.559","Z01.818","R60.0","R03.0","Z96.653"],"date":["2020-11-25","2021-05-15","2021-06-01","2022-07-05","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2021-06-17","2021-08-20","2021-08-20","2022-11-01","2021-12-13","2021-12-13","2022-06-24","2022-02-02","2022-02-02","2022-02-02","2022-02-02","2022-02-02","2022-02-07","2022-02-07","2022-02-07","2022-08-09","2022-09-21","2022-08-09","2022-08-09","2022-08-09","2022-08-09","2021-12-16","2020-10-29","2021-12-16","2020-10-29","2020-10-29","2021-04-20","2020-11-03","2022-11-21","2022-11-21","2021-10-19","2021-10-19","2021-04-21","2021-04-21","2021-08-03","2022-02-02","2022-06-26","2022-06-26","2022-06-26","2022-07-05","2022-07-05","2022-07-05","2022-07-05","2022-07-05","2022-04-06","2022-04-06","2021-03-18","2021-03-18","2021-07-09","2022-05-16","2022-10-07","2021-06-01","2021-12-13","2022-06-26","2022-06-26","2022-06-26","2022-11-01","2021-04-20","2021-04-20","2021-04-20","2021-05-06","2021-05-06","2021-05-15","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2022-05-16","2022-06-06","2022-06-06","2022-06-06","2022-06-14","2022-06-26","2022-07-11","2022-09-12"],"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":[]},{"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":[["","31722071390","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","00054001829","PREDNISONE","TAB 20MG","10","Select","Select",""],["","00456120130","LINZESS","CAP 145MCG","90","Select","Select",""],["","68462018022","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","21922001707","CLOBETASOL","OIN 0.0005","60","Select","Select",""],["","16729022701","SPIRONOLACT","TAB 100MG","30","Select","Select",""],["","00555097302","AMPHET\/DEXTR","TAB 20MG","60","Select","Select",""],["","00254101196","SUCRALFATE","SUS 1GM\/10ML","1200","Select","Select",""],["","51991070510","ALPRAZOLAM","TAB 0.5MG","60","Select","Select",""],["","68001024604","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","55111018010","TIZANIDINE","TAB 4MG","90","Select","Select",""],["","72578000105","DOXYCYCL","TAB 100MG","28","Select","Select",""],["","00406324301","HYDROMORPHON","TAB 2MG","40","Select","Select",""],["","00093216568","NALOXONE","SPR 4MG","2","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","25","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","20","Select","Select",""],["","00904699880","DOCUSATE","CAP 100MG","5","Select","Select",""],["","65862020199","LOSARTAN","TAB 25MG","30","Select","Select",""],["","00536123441","ASPIRIN","TAB 81MG EC","60","Select","Select",""],["","51672139409","TRETINOIN","CRE 0.0005","45","Select","Select",""],["","00480204456","VILAZODONE","TAB 20MG","30","Select","Select",""],["","51991000633","DESVENLAFAX","TAB 25MG ER","30","Select","Select",""],["","13668001005","CITALOPRAM","TAB 20MG","30","Select","Select",""],["","50228017505","BUPROPION","TAB 150MG SR","30","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","30","Select","Select",""],["","59746012106","MECLIZINE","TAB 25MG","20","Select","Select",""],["","65649030302","XIFAXAN","TAB 550MG","42","Select","Select",""],["","46122038576","24","SPR ALLERGY","17","Select","Select",""],["","68001000501","METHYLPRED","TAB 4MG","21","Select","Select",""],["","52565008530","GENTAMICIN","CRE 0.001","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":""}]}]}