{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VASTISH M COOPER","gend":1,"add":"1310 PORTER LN APT 33","city":"SOUTH BOSTON","state":"VA","zip":"24592-9998","dob":"1986-11-20","age":"","mstatus":"","insh":"1692105*01","cliId":"","pno":4345489112,"cno":4345489112,"email":"","ename":"","eno":"","pphy":"OLINGER, AUGUST S NP","ppno":4347994444,"pcpadd":"305 N MAIN ST,","pcpcity":"GRETNA","pcpstate":"VA","pcpzip":"24557-9998","pcpcounty":"","pcpid":"","pcpname":"Sovah Internal Medicine Danville","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4346563988,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E66.01","Z51.81","Z79.899","Z68.43","I10.","E78.5","D50.8","T50.905A","E66.9","Z87.891","K08.89","F41.9","Z71.3","R11.14","R11.0","Z20.822","R19.7","Z20.828","O03.4","Z3A.09","Z01.419","Z72.0","Z71.9","N76.0","B96.89","N92.6","G47.30","I87.2","I83.92","M21.6X2","M21.6X1","M79.672","M79.671","M72.2","T40.2X1A","R42.","R11.2","D64.9","E55.9","Z11.59","F54.","NO DATA","Z68.42","M25.50","N39.0","R31.9","K91.2","R60.9","F17.200","D50.9","G47.8","R73.09","Z76.89","M25.572","O02.1","G24.5","F41.8","F10.10","Z11.8"],"date":["2023-08-29","2023-02-27","2023-02-27","2023-02-13","2023-08-29","2021-11-23","2021-11-23","2022-08-06","2023-02-13","2023-02-13","2022-08-06","2023-08-29","2023-02-07","2023-02-13","2023-02-13","2023-02-13","2023-02-13","2021-04-02","2021-08-03","2021-08-03","2022-10-05","2022-10-05","2023-04-06","2023-04-06","2023-04-06","2022-10-05","2021-10-26","2021-08-10","2021-08-10","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2022-08-06","2022-08-06","2022-08-06","2023-08-29","2023-08-29","2022-10-25","2023-01-20","2023-01-20","2022-05-25","2022-01-14","2022-05-16","2022-05-16","2022-08-18","2021-08-10","2021-07-27","2023-02-27","2022-06-27","2021-04-12","2021-04-12","2021-05-07","2021-08-31","2022-06-27","2022-06-27","2022-10-17","2023-04-06"],"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":[["","10702002903","PHENTERMINE","CAP 37.5MG","30","Select","Select",""],["","75834002012","VITAMIN D","3 1250 MCG","8","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","59651036205","IBUPROFEN","800 MG","63","Select","Select",""],["","00054429731","FUROSEMIDE","TAB 20MG","90","Select","Select",""],["","00169450514","WEGOVY","INJ 0.5MG","2","Select","Select",""],["","65862020199","LOSARTAN POT","TAB 25MG","30","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","30","Select","Select",""],["","00245010811","FERROUS SULF","TAB 325MG EC","90","Select","Select",""],["","75834002012","VITAMIN D3","CAP 50000UNT","4","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","30","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","14","Select","Select",""],["","65862001705","AMOXICILLIN","500 MG","21","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","20","Select","Select",""],["","68180031909","BUPROPN HCL","TAB 150MG XL","30","Select","Select",""],["","00074376960","OMNICEF","CAP 300MG","20","Select","Select",""],["","60505265301","TRAZODONE","TAB 50MG","30","Select","Select",""],["","00169280015","SAXENDA","INJ 18MG\/3ML","15","Select","Select",""],["","16500009713","FLINTSTONES","CHW COMPLETE","92","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","42806031250","DOXYCYCL HYC","TAB 100MG","14","Select","Select",""],["","40985021151","B-1","TAB 100MG","30","Select","Select",""],["","00761044020","VITAMIN B-12","TAB 500MCG","30","Select","Select",""],["","00005556819","CALTRATE 600","CHW 600-800","184","Select","Select",""],["","11917013972","B-12","TAB 500MCG","30","Select","Select",""],["","10702002501","PHENTERMINE HCL","37.5 MG","30","Select","Select",""],["","65862020299","LOSARTAN POTASSIUM","50 MG","30","Select","Select",""],["","57237007710","ONDANSETRON ODT","4 MG","8","Select","Select",""],["","68180032002","BUPROPION XL","300 MG","30","Select","Select",""],["","50111033402","METRONIDAZOLE","500 MG","14","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","5","Select","Select",""],["","68462019005","NAPROXEN TAB","500MG","14","Select","Select",""],["","57237002801","AMOXICILLIN TAB","500MG","30","Select","Select",""],["","65862020199","LOSARTAN POT TAB","25MG","30","Select","Select",""],["","64380080707","IBUPROFEN TAB","800MG","15","Select","Select",""],["","10702002903","PHENTERMINE CAP","37.5MG","30","Select","Select",""],["","00074376960","OMNICEF CAP","300MG","20","Select","Select",""],["","68180031909","BUPROPN HCL TAB","150MG XL","30","Select","Select",""],["","65862017760","CEFDINIR CAP","300MG","20","Select","Select",""],["","60505265301","TRAZODONE TAB","50MG","30","Select","Select",""],["","65862001705","AMOXICILLIN CAP","500MG","30","Select","Select",""],["","16500009713","FLINTSTONES CHW COMPLETE","","92","Select","Select",""],["","00005556819","CALTRATE","600 CHW 600-800","60","Select","Select",""],["","00169280015","SAXENDA INJ","18MG\/3ML","15","Select","Select",""],["","11917013972","B-","12 TAB 500MCG","30","Select","Select",""],["","68382005105","MELOXICAM TAB","15MG","30","Select","Select",""],["","00761044020","VITAMIN B-","12 TAB 500MCG","92","Select","Select",""],["","50111033402","METRONIDAZOL TAB","500MG","14","Select","Select",""],["","42806031250","DOXYCYCL HYC TAB","100MG","14","Select","Select",""],["","64679060416","PROMETHAZINE-DM","6.25-15\/5","168","Select","Select",""],["","60258015001","SF","5000 PLUS 1.1 %","51","Select","Select",""],["","00591544210","PREDNISONE","10 MG","5","Select","Select",""],["","69367030951","SODIUM FLUORIDE","5000 PLUS 1.1 %","51","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":""}]}]}