{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CAITLYNN KIRBY","gend":1,"add":"699 CROWS ROAD","city":"GLADYS","state":"VA","zip":"24554-9998","dob":"2003-03-05","age":"","mstatus":"","insh":"1279191*01","cliId":"","pno":4346652762,"cno":4346652762,"email":"","ename":"","eno":"","pphy":"KILEL, JENNIFER NP","ppno":4349475967,"pcpadd":"320 FEDERAL ST","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":"24504-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4349475971,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R10.2","R10.84","R11.2","R06.02","J45.901","R06.2","R06.00","R05.9","E87.6","Z86.59","Z72.0","F32.1","L40.4","J45.40","J30.9","S16.1XXA","V87.7XXA","M62.838","M25.512","J45.909","F41.8","Z87.891","R94.31","J45.902","J96.92","G93.6","G93.5","Z51.5","Z20.822","G93.1","E87.4","R09.02","E87.5","G25.3","G93.49","I46.8","G43.909","R07.89","F41.9","NO DATA","R06.03","I46.9","F12.90","G93.40","F17.290","R41.82"],"date":["2022-02-04","2022-06-29","2022-06-29","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-12-31","2022-10-14","2022-10-14","2021-08-31","2021-05-27","2022-03-04","2021-05-27","2021-12-17","2021-12-17","2021-03-01","2021-03-01","2022-12-31","2021-03-01","2022-06-15","2022-06-15","2022-12-31","2022-12-31","2022-12-31","2022-12-31","2022-12-31","2022-12-31","2022-12-31","2022-12-31","2022-12-31","2022-12-31","2022-12-31","2022-12-31","2022-12-31","2022-04-03","2022-06-15","2022-06-29","2022-12-31","2022-10-14","2023-01-01","2022-12-31","2023-01-01","2022-06-29","2023-01-01"],"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":[["","00093005301","BUSPIRONE","TAB 5MG","90","Select","Select",""],["","80681005000","DAILY-VITE","TAB ","60","Select","Select",""],["","80681004002","MELATONIN","TAB 5MG","30","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","80681002000","MULTIVITAMIN","TAB ","30","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","00135061601","FLONASE SENS","SUS 27.5MCG","6","Select","Select",""],["","00378932232","WIXELA INHUB","AER 500\/50","60","Select","Select",""],["","70954006020","PREDNISONE","TAB 20MG","12","Select","Select",""],["","00173069700","ADVAIR DISKU","AER 500\/50","60","Select","Select",""],["","66993058697","FLUTIC\/SALME","AER 500\/50","60","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","00713067653","TRIAMCINOLON","LOT 0.001","60","Select","Select",""],["","65862064230","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","14","Select","Select",""],["","00143980305","DOXYCYCL HYC","CAP 100MG","28","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","00378334053","XULANE","DIS 150-35","9","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":""}]}]}