{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KAREN R GLASS","gend":1,"add":"238 PARKLAND DR 104A","city":"DANVILLE","state":"VA","zip":"24540-9998","dob":"1977-08-17","age":"","mstatus":"","insh":"1868898*01","cliId":"","pno":4342508361,"cno":4342508361,"email":"","ename":"","eno":"","pphy":"CHAPELL, PATTY J NP","ppno":4348354875,"pcpadd":"949 PINEY FOREST RD,","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24540-9998","pcpcounty":"","pcpid":"","pcpname":"GoDocs","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4348354875,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R53.83","F50.81","Z71.3","Z71.82","Z68.41","E66.01","I10.","F41.9","F32.9","F41.0","F60.3","R45.86","F43.12","E78.5","D64.9","E11.9","M79.7","G43.909","E55.9","E53.8","K21.9","F33.1","Z68.39","E66.9","N39.0","R31.9","R30.0","R80.9","I47.1","I48.0","M13.0","M79.641","M79.642","M70.71","M70.72","M54.5","J30.2","R07.0","R09.82","R09.81","D51.9","R07.9","N92.0","S63.91XA","B00.9","L82.1","L70.0","B35.1","R11.0","R10.13","NO DATA","Z86.16","R06.02","N91.2","M17.11","M17.12","R70.0","Z28.89"],"date":["2023-05-26","2022-05-05","2022-03-14","2022-03-14","2022-02-09","2022-09-26","2022-09-26","2022-09-26","2022-09-26","2022-06-02","2022-06-02","2022-06-16","2022-05-05","2022-05-05","2023-05-26","2022-09-26","2022-09-26","2021-04-06","2021-04-06","2023-05-26","2022-09-26","2021-05-27","2022-03-14","2022-03-14","2022-10-03","2023-05-26","2022-10-03","2022-10-03","2021-01-04","2021-01-04","2023-05-26","2023-05-26","2023-05-26","2021-01-14","2021-01-14","2021-01-14","2022-04-06","2022-04-06","2022-04-06","2022-09-26","2021-01-06","2021-01-06","2021-01-06","2021-05-24","2022-06-02","2022-02-15","2022-02-15","2022-02-15","2022-04-26","2022-04-26","2023-05-26","2022-09-26","2022-09-26","2022-09-26","2023-05-26","2023-05-26","2023-05-26","2023-05-26"],"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":[["","80681017000","VITAMIN D","3 50 MCG","90","Select","Select",""],["","52427066430","SERTRALINE HCL","150 MG","30","Select","Select",""],["","16714089802","LORATADINE","10 MG","30","Select","Select",""],["","55111018015","TIZANIDINE HCL","4 MG","120","Select","Select",""],["","59746017509","PREDNISONE","20 MG","5","Select","Select",""],["","00169450514","WEGOVY","0.5MG\/.5ML","1","Select","Select",""],["","40985027112","B-","12 2500 MCG","30","Select","Select",""],["","59762500006","SULFASALAZINE","500 MG","120","Select","Select",""],["","31722066530","ESOMEPRAZOLE MAGNESIUM","40 MG","30","Select","Select",""],["","68462015713","ONDANSETRON ODT","4 MG","30","Select","Select",""],["","68382056510","METOPROLOL SUCCINATE","50 MG","30","Select","Select",""],["","61874011530","VRAYLAR","1.5 MG","30","Select","Select",""],["","00406048410","ACETAMINOPHEN-CODEINE","300MG-30MG","24","Select","Select",""],["","65862044830","VALACYCLOVIR","500 MG","90","Select","Select",""],["","70700015010","OMEPRAZOLE","20 MG","90","Select","Select",""],["","29300041319","CYCLOBENZAPRINE HCL","5 MG","30","Select","Select",""],["","00116200116","CHLORHEXIDINE GLUCONATE","0.12 %","473","Select","Select",""],["","68645056354","IBUPROFEN","800 MG","60","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","70010016305","CETIRIZINE HCL","10 MG","30","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":""}]}]}