{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WENDY   M STRICKLAND","gend":1,"add":"18557 MONROVIA ROAD","city":"ORANGE","state":"VA","zip":"22960-9998","dob":"1969-06-18","age":"","mstatus":"","insh":"2156922*01","cliId":"","pno":"540\/229-3668","cno":"","email":"","ename":"","eno":"","pphy":"GIESE, MATTHEW R MD","ppno":"540\/672-3010","pcpadd":"13198 JAMES MADISON HWY","pcpcity":"ORANGE","pcpstate":"VA","pcpzip":22960,"pcpcounty":"","pcpid":"","pcpname":"AHG - Orange Family Physicians","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/672-5713","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.10","R00.0","F43.12","Z23.","F10.20","F41.1","F17.210","F43.10","J44.9","R10.12","R11.0","R19.7","R05.","F32.9","Z91.410","Z79.899","Z79.82","Z79.1","R53.83","Z81.1","Z81.8","Z82.49","Z82.5","J43.9","R09.89","Z87.891","N95.1","F10.230","U07.1","J44.1","I10.","E66.9","Z68.31","NO DATA","Z79.51","F10.239","F11.20","F33.1","R06.02","Z53.21","R91.1","K29.70","K57.90","G47.00","E87.2","E86.0","Y90.9","F32.1","F17.200","R09.02","R07.9","Z20.822","K76.0","R05.9","Z86.16","Z88.5","Z98.51","Z99.81","J45.901","K83.8","R74.8","R79.89","S39.91XA","R06.09","Z98.890","J98.4","R40.0","Z12.2","F10.99","R74.01","E78.5"],"date":["2020-07-23","2022-04-07","2021-02-11","2021-04-02","2022-05-25","2022-05-25","2022-05-25","2022-05-25","2022-10-11","2020-05-14","2020-05-14","2020-06-02","2020-05-14","2020-06-24","2020-05-14","2022-06-13","2020-05-14","2020-05-14","2020-05-14","2020-05-14","2020-05-14","2021-12-23","2020-05-14","2020-09-01","2020-09-01","2020-09-01","2020-09-01","2022-05-18","2022-06-13","2022-06-13","2022-05-19","2021-12-23","2021-12-23","2022-05-19","2022-06-13","2022-04-07","2022-05-20","2022-05-22","2022-06-16","2022-06-16","2021-03-10","2020-06-02","2020-06-02","2022-02-03","2022-04-08","2022-04-08","2022-04-07","2022-04-22","2022-04-22","2022-05-10","2022-05-11","2022-05-10","2022-06-13","2022-06-13","2022-06-13","2022-06-13","2022-06-13","2022-06-13","2022-06-13","2020-05-14","2020-05-14","2020-05-14","2020-05-21","2020-07-28","2022-04-08","2020-06-24","2020-06-24","2020-06-24","2022-05-11","2022-05-11","2022-05-11"],"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":[["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","68462039610","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","16729011917","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","68001035603","METOPROL","TAB 25MG ER","30","Select","Select",""],["","10006073038","MAG","TAB 400MG","30","Select","Select",""],["","68382056928","ACAMPRO","TAB 333MG","180","Select","Select",""],["","00406117001","NALTREXONE","TAB 50MG","7","Select","Select",""],["","00536302934","NICOTINE","GUM 2MG ORIG","40","Select","Select",""],["","31722088290","ROSUVASTATIN","TAB 5MG","30","Select","Select",""],["","64980033912","MAGNESIUM-OX","TAB 400MG","30","Select","Select",""],["","68180035302","SERTRALINE","TAB 100MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","23155050201","HYDROXYZ","TAB 50MG","60","Select","Select",""],["","46122035374","GNP","DIS 21MG\/24H","28","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","64764075030","TRINTELLIX","TAB 20MG","30","Select","Select",""],["","68382003510","VENLAFAXINE","CAP 75MG ER","30","Select","Select",""],["","50111056003","TRAZODONE","TAB 50MG","14","Select","Select",""],["","43547028950","BUPROPION","TAB 150MG SR","60","Select","Select",""],["","59267102504","PFIZER","INJ ADLT RTU","0","Select","Select",""],["","00172392680","DIAZEPAM","TAB 5MG","10","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","87701040729","VITAMIN","TAB 100MG","30","Select","Select",""],["","42806071405","BENZONATATE","CAP 100MG","30","Select","Select",""],["","00069108530","PAXLOVID","TAB 300-100","30","Select","Select",""],["","00555015902","CHLORDIAZEP","CAP 25MG","14","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","14","Select","Select",""],["","70954001910","PRAZOSIN","CAP 1MG","30","Select","Select",""],["","63402051001","XOPENEX","AER ","15","Select","Select",""],["","69584009310","BUSPIRONE","TAB 15MG","60","Select","Select",""],["","16729017217","AMITRIPTYLIN","TAB 25MG","30","Select","Select",""],["","00173086910","ANORO","AER 62.5-25","60","Select","Select",""],["","76204090025","LEVALBUTEROL","NEB 1.25MG","75","Select","Select",""],["","62332009830","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","16729010912","QUETIAPINE","TAB 150MG ER","23","Select","Select",""],["","65862053750","LEVOFLOXACIN","TAB 500MG","10","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","00173089310","TRELEGY","AER ELLIPTA","60","Select","Select",""],["","65862064163","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","76204010025","IPRATROPIUM","SOL 0.02%INH","62","Select","Select",""],["","52817033250","CYCLOBENZAPR","TAB 10MG","40","Select","Select",""],["","10572010001","PEG-3350","SOL ELECTROL","4000","Select","Select",""],["","59762040101","SUCRALFATE","TAB 1GM","40","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","56","Select","Select",""],["","00406012310","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","68001024604","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","00781196260","CLARITHROMYC","TAB 500MG","28","Select","Select",""],["","10702001850","OXYCODONE","TAB 5MG","10","Select","Select",""],["","52268001201","SUPREP","SOL PREP KIT","354","Select","Select",""],["","42571016242","AMOX\/K","TAB 875-125","20","Select","Select",""],["","69543025216","VIRTUSSIN","SOL 100-10\/5","200","Select","Select",""],["","68462018022","MUPIROCIN","OIN 0.02","22","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":""}]}]}