{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAMIKA   D PAINTER","gend":1,"add":"813 IVY ST","city":"WAYNESBORO","state":"VA","zip":"22980-9998","dob":"1981-07-20","age":"","mstatus":"","insh":"7353871*01","cliId":"","pno":"540\/241-9091","cno":"540\/221-9481","email":"","ename":"","eno":"","pphy":"HEALD, EVAN B 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":"M4","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":["K08.89","B37.0","F31.9","F90.0","F41.1","K56.1","Z98.84","M79.7","M53.3","E55.9","E61.1","E53.8","E50.9","R10.32","B34.9","Z20.822","F32.9","F41.9","F90.9","Z79.899","Z88.5","NO DATA","S89.92XA","S61.411A","N76.0","B37.3","N89.8","Z11.3","K95.89","E44.1","E66.9","K21.9","Z90.49","Z98.890","Z72.51","J02.9","R06.02","Z20.828","I80.8","B07.0","M79.671","M79.672","M79.605","S80.12XA","F39.","F90.1","K66.0","G47.33","Z68.37","M25.551","R20.0","G56.03","R20.2","Z01.419","N39.46","N81.9","T81.72XA","M79.89","S29.012A","X50.0XXA","R05.9","R19.7","R51.9","U07.1","Z88.6","Z01.818","L03.116","N83.201","N83.202","J98.9","R10.31","R39.9","Z23.","F33.1","R06.00","B07.9","N83.209","R10.2","S99.922A","Y93.11","G89.11","M25.552","J45.909","F15.21","F43.12","J20.9"],"date":["2021-11-07","2022-06-04","2022-01-18","2022-01-18","2022-01-18","2021-09-07","2022-01-05","2021-12-17","2021-12-17","2022-03-01","2022-03-01","2022-03-01","2022-03-01","2021-09-24","2021-12-04","2022-10-20","2021-12-04","2022-07-12","2022-02-10","2022-05-01","2022-05-01","2022-01-26","2020-11-13","2020-08-07","2021-12-18","2021-12-18","2021-12-18","2022-09-17","2021-09-06","2021-07-20","2021-09-06","2021-07-20","2021-07-20","2021-11-23","2020-04-23","2022-02-06","2021-01-30","2021-01-30","2021-09-09","2022-03-18","2022-03-18","2022-03-18","2020-11-13","2020-11-13","2022-02-06","2020-11-13","2021-09-07","2021-09-06","2021-09-06","2021-12-17","2021-12-17","2022-01-05","2021-12-17","2020-01-07","2020-01-17","2020-01-17","2021-09-09","2021-09-09","2019-09-18","2019-09-18","2022-02-10","2022-01-11","2022-01-11","2022-02-10","2022-05-01","2022-03-01","2022-03-04","2022-05-01","2022-05-01","2022-05-01","2022-05-01","2022-09-17","2022-09-17","2022-07-12","2022-02-10","2022-03-18","2022-05-09","2022-05-09","2022-08-08","2022-08-08","2022-01-26","2022-01-26","2022-02-10","2022-06-30","2022-06-30","2022-10-20"],"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":[["","80681012800","VITAMIN","TAB 500MCG","30","Select","Select",""],["","31604002706","D3","CHW 1000UNIT","60","Select","Select",""],["","","TRAZODONE","TAB 100MG","","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","00904759180","FEROSUL","TAB 325MG","30","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","20","Select","Select",""],["","81131077943","EQ","TAB WOMENS","60","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","00093005405","BUSPIRONE","TAB 10MG","120","Select","Select",""],["","55111053401","DIVALPROEX","TAB 500MG ER","60","Select","Select",""],["","00591365930","DESVENLAFAX","TAB 50MG ER","30","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","Select","Select",""],["","00472016630","NYSTATIN","OIN 100000","30","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","68462030329","HEATHER","TAB 0.35MG","84","Select","Select",""],["","00054414622","CLOTRIMAZOLE","TRO 10MG","70","Select","Select",""],["","10702001250","HYDROXYZ","TAB 50MG","60","Select","Select",""],["","13668001005","CITALOPRAM","TAB 20MG","30","Select","Select",""],["","55111015430","ONDANSETRON","TAB 8MG","20","Select","Select",""],["","68180065208","DOXYCYC","CAP 100MG","14","Select","Select",""],["","45802001402","HYDROCORT","OIN 0.025","20","Select","Select",""],["","","AZITHROMYCIN","TAB 500MG","","Select","Select",""],["","31722095801","BENZONATATE","CAP 200MG","21","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","70954006020","PREDNISONE","TAB 20MG","21","Select","Select",""],["","","BUPROPN","TAB 300MG XL","","Select","Select",""],["","49035052378","ACETAMINOPHN","TAB 325MG","48","Select","Select",""],["","50383077504","LIDOCAINE","SOL 2% VISC","100","Select","Select",""],["","59746011306","PROCHLORPER","TAB 5MG","30","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","15","Select","Select",""],["","81131011187","B-12","SUB 500MCG","30","Select","Select",""],["","80681014000","CALCIUM","TAB 200MG","180","Select","Select",""],["","49483034010","ACETAMIN","TAB 325MG","40","Select","Select",""],["","69618004410","DOCUSATE","CAP 100MG","10","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","90","Select","Select",""],["","00093117410","PENICILLN","TAB 500MG","28","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","10","Select","Select",""],["","35573043556","SODIUM","GEL 0.011","56","Select","Select",""],["","50428032507","SPECTRAVITE","TAB ","120","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","49035030882","PAIN","TAB 500MG","24","Select","Select",""],["","","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","00904671960","ACETAMINOPHE","TAB 325MG","48","Select","Select",""],["","43598075360","BUPROPION","TAB 200MG SR","30","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","","REXULTI","TAB 3MG","","Select","Select",""],["","","MICONAZOLE","CRE 0.02","","Select","Select",""],["","64980030550","DENTA","CRE PLUS","51","Select","Select",""],["","","DULOXETINE","CAP 30MG","","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","60505283303","ATOMOXETINE","CAP 40MG","30","Select","Select",""],["","00126007292","PREVDNT","PST 0.011","100","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","15","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":""}]}]}