{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAZMYN V DUGUID","gend":1,"add":"835 FAIRVIEW VILLAGE CT","city":"CULPEPER","state":"VA","zip":"22701-9998","dob":"1986-07-15","age":"","mstatus":"","insh":"1389917*01","cliId":"","pno":5714468513,"cno":5714468513,"email":"","ename":"","eno":"","pphy":"PROFFITT, MICHELLE COLLINS NP","ppno":5408256263,"pcpadd":",","pcpcity":"CULPEPER","pcpstate":"VA","pcpzip":"22701-9998","pcpcounty":"","pcpid":"","pcpname":"Compassion Health Care Inc, dba Caswell Family Medical Center","plan":"OHP","program":"MEDICAID","lob":"M4","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5408254911,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.2","S89.91XA","F41.8","G43.009","R51.9","R20.0","R11.0","M23.91","R10.32","R19.7","R63.0","Z90.711","Z90.79","S83.8X1A","D64.9","G43.909","Z79.899","Z88.8","Z88.4","Z98.51","M25.561","Z01.818","R10.2","G89.29","I87.8","A60.00","Z88.5","R30.0","N80.9","N73.6","G89.18","Z09.","Z90.710","A60.9","G44.53","F41.9","NO DATA","Z48.816","Z98.890","R10.9","J01.90"],"date":["2022-08-04","2021-07-29","2023-07-05","2023-07-05","2022-12-08","2023-01-21","2022-12-08","2021-09-09","2022-09-03","2022-09-03","2022-09-03","2022-09-03","2022-09-03","2021-07-23","2021-07-23","2021-07-23","2021-09-30","2021-07-29","2022-01-28","2021-07-23","2021-09-30","2022-02-28","2022-04-08","2021-09-30","2022-01-28","2022-01-28","2022-01-28","2022-01-28","2022-04-08","2022-04-08","2022-04-08","2022-05-05","2022-05-05","2023-04-05","2023-01-21","2023-04-05","2023-04-05","2022-04-15","2022-04-15","2022-01-28","2022-06-18"],"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":[["","42858000101","OXYCODONE","TAB 5MG","10","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","68180087673","NORETHINDRON","TAB 0.35MG","84","Select","Select",""],["","49035048462","ACETAMINOPHN","TAB 500MG","2","Select","Select",""],["","50228018010","GABAPENTIN","300 MG","90","Select","Select",""],["","65862091060","CELECOXIB","CAP 400MG","1","Select","Select",""],["","49035053112","EQ ACETAMIN","TAB 500MG","2","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","22","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","15","Select","Select",""],["","42192060716","BROM\/PSE\/DM","SYP 2\/30\/10","240","Select","Select",""],["","69238110002","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","31722077801","ACYCLOVIR","800 MG","10","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","68382000514","TOPIRAMATE","CAP 25MG","30","Select","Select",""],["","33342009441","RIZATRIPTAN","10 MG","10","Select","Select",""],["","57237017301","VENLAFAXINE HCL","37.5 MG","7","Select","Select",""],["","43547028111","ESCITALOPRAM OXALATE","10 MG","90","Select","Select",""],["","69238207801","PROPRANOLOL HCL","20 MG","90","Select","Select",""],["","63948016843","RIBOFLAVIN","400 MG","90","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":""}]}]}