{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JESSICA DOWNEY","gend":1,"add":"2127 GIANT GRAVE RD APT A","city":"ELKTON","state":"VA","zip":"22827-9998","dob":"1992-01-10","age":"","mstatus":"","insh":"1515061*01","cliId":"","pno":5402447993,"cno":5402447993,"email":"","ename":"","eno":"","pphy":"VARGA, KAROLY MD","ppno":5406895400,"pcpadd":"2006 HEALTH CAMPUS DR STE 300,","pcpcity":"HARRISONBURG","pcpstate":"VA","pcpzip":"22801-9998","pcpcounty":"","pcpid":"","pcpname":"SRMHMG - Sentara Neurology Specialists - Harrisonburg","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7575798568,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.9","R42.","R10.9","R51.9","F41.9","F39.","F43.10","F60.3","F41.1","N94.6","N92.0","M54.6","M54.5","M25.512","S13.9XXA","S33.5XXA","M54.9","G89.29","R10.32","N93.9","G43.011","R53.1","NO DATA","R63.4","E66.01","Z68.32","R10.30","Z63.9","Z65.9","F12.90","Z86.59","R07.89","G44.89","F31.9","Z76.0","Z81.8","Z88.5","Z88.3","Z91.041","Z91.040","G44.201","J45.20","M62.08","K42.9","J45.909","Z79.1","Z79.51","Z79.899","J06.9","R50.9","R31.9","D50.9","Z20.822","N10.","F43.9"],"date":["2021-06-05","2021-06-05","2021-06-29","2023-09-20","2022-10-14","2021-01-07","2021-01-07","2021-01-07","2022-10-14","2021-06-21","2021-06-21","2021-06-24","2021-06-24","2021-06-24","2021-06-24","2021-06-24","2021-06-24","2022-06-26","2021-07-14","2021-07-04","2022-05-08","2022-12-02","2022-12-02","2022-12-02","2022-12-02","2022-12-02","2022-12-02","2021-01-07","2021-01-07","2021-01-07","2023-09-20","2022-04-29","2022-04-29","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-05-07","2022-05-07","2021-07-14","2021-07-14","2022-06-26","2022-06-26","2022-06-26","2022-06-26","2023-08-25","2023-08-25","2023-08-25","2023-08-25","2023-08-25","2023-07-16","2023-09-20"],"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":[]},{"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":[["","00173069700","ADVAIR DISKU AER","500\/50","60","Select","Select",""],["","00781261305","AMOXICILLIN CAP","500MG","30","Select","Select",""],["","00093317431","ALBUTEROL AER HFA","","8","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","66993058697","FLUTIC\/SALME AER","500\/50","60","Select","Select",""],["","70700015010","OMEPRAZOLE CAP","20MG","30","Select","Select",""],["","55111015330","ONDANSETRON TAB","4MG","30","Select","Select",""],["","13668000905","CITALOPRAM TAB","10MG","7","Select","Select",""],["","00173069700","ADVAIR DISKUS","500-50 MCG","60","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","66993058697","FLUTICASONE-SALMETEROL","500-50 MCG","60","Select","Select",""],["","68001025317","FLUCONAZOLE","150 MG","2","Select","Select",""],["","76204020060","ALBUTEROL SULFATE","2.5 MG\/3ML","180","Select","Select",""],["","57896086905","PROBIOTIC","250 MG","20","Select","Select",""],["","65862001401","AMOXICILLIN","500 MG","30","Select","Select",""],["","65862007701","CIPROFLOXACIN HCL","500 MG","20","Select","Select",""],["","60505082901","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","65162019011","NAPROXEN","500 MG","20","Select","Select",""],["","66993058697","FLUTIC\/SALME","AER 500\/50","60","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00173069700","ADVAIR DISKU","AER 500\/50","60","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","70700015010","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","13668000905","CITALOPRAM","TAB 10MG","7","Select","Select",""],["","68382013805","TOPIRAMATE","25 MG","100","Select","Select",""],["","55111029236","SUMATRIPTAN SUCCINATE","50 MG","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":""}]}]}