{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEBORAH  F CRIDER","gend":1,"add":"260 TELLURIDE DR","city":"BROADWAY","state":"VA","zip":"22815-9998","dob":"1956-10-10","age":"","mstatus":"","insh":"20009407*01","cliId":"","pno":5402467582,"cno":5402467582,"email":"","ename":"","eno":"","pphy":"HOTCHKISS, JEROME J MD","ppno":5404334913,"pcpadd":"1380 LITTLE SORRELL DRIVE SUITE 100","pcpcity":"HARRISONBURG","pcpstate":"VA","pcpzip":"22801-9998","pcpcounty":"","pcpid":"","pcpname":"Healthy Community Health Center - Stone Port (HCHC-Stone Port)","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5404334915,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","N39.3","R39.81","F25.0","G21.19","Z79.899","E05.90","E55.9","Z23.","R63.5","T50.905A","Z65.9","Z51.81","M81.0","F39.","I10.","F32.9","G43.909","G89.29","I25.10","R06.00","B35.1","F17.200","S06.0X0A","J44.9","I25.2","Z95.1","F17.210","Z88.1","Z88.6","Z88.0","Z91.030","Z91.041","R42.","M79.671","M79.672","L60.3","J43.2","K21.9","Z12.2","J43.9","R91.8"],"date":["2023-04-05","2023-04-11","2023-04-11","2023-02-01","2022-08-02","2022-08-02","2022-06-21","2022-06-21","2021-06-25","2022-08-02","2022-08-02","2022-08-02","2023-02-01","2021-01-06","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-07-12","2022-04-01","2021-04-16","2021-04-16","2021-04-16","2021-04-16","2022-08-12","2021-04-16","2021-04-16","2021-04-16","2021-04-16","2021-04-16","2021-04-16","2022-07-12","2022-07-12","2022-07-12","2022-07-19","2022-07-19","2022-08-12","2022-08-12","2022-08-12"],"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":[["","00093719801","FLUOXETINE","CAP 40MG","90","Select","Select",""],["","12496120803","SUBOXONE","8 MG-2 MG","60","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","65862049101","QUETIAPINE","TAB 100MG","30","Select","Select",""],["","67877056305","METFORMIN","TAB 1000MG","30","Select","Select",""],["","00603243721","BENZTROPINE","TAB 0.5MG","181","Select","Select",""],["","67877043203","ARIPIPRAZOLE","10 MG","90","Select","Select",""],["","68180047903","SIMVASTATIN","20 MG","90","Select","Select",""],["","00093598627","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","23155007001","METHIMAZOLE","TAB 5MG","15","Select","Select",""],["","47781035703","BUPREN\/NALOX","MIS 8-2MG","60","Select","Select",""],["","44523061701","UREA","CRE 0.4","198","Select","Select",""],["","00597010061","SPIRIVA","SPR 2.5MCG","4","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","65862014736","SUMATRIPTAN SUCCINATE","50 MG","10","Select","Select",""],["","00093719801","FLUOXETINE HCL","40 MG","90","Select","Select",""],["","47781035703","BUPRENORPHINE-NALOXONE","8 MG-2 MG","56","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":""}]}]}