{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CANDI  R SHIFLETT","gend":1,"add":"179 JERRY HILL DR","city":"CRIMORA","state":"VA","zip":"24431-9998","dob":"1982-03-11","age":"","mstatus":"","insh":"20011375*01","cliId":"","pno":5408367820,"cno":5408367820,"email":"","ename":"","eno":"","pphy":"LAWRENCE, JENILEE V MD","ppno":5402132630,"pcpadd":"22 N MEDICAL PARK DR","pcpcity":"FISHERSVILLE","pcpstate":"VA","pcpzip":"22939-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5402132631,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z12.4","I10.","E03.8","E78.00","F41.9","E28.39","Z94.0","N18.5","Z98.84","Z68.38","K90.89","Z01.818","R20.2","T82.590A","T82.898A","E07.9","Z79.899","Z87.448","N18.6","N25.81","V58.89","R60.1","I15.1","R05.9","R09.81","R80.1","R73.03","E66.01","E03.9","Z48.298","Z71.85","E21.2","E55.9","J06.9","Z51.89","I77.0","Z99.2","Z48.812","Z71.89","E66.09","Z68.34","D75.1","T82.848A","Z53.21","Z28.310","Z23.","K21.9","Z86.16","J02.9","Z20.822","M79.89","Z12.83","D84.9","D22.5","Q82.5","D22.61","D22.62","D22.71","D22.72","R53.83","R10.84","R07.9","R61.","K30.","R14.0","N93.9","R10.31","R35.0","U07.1"],"date":["2021-01-07","2022-03-29","2021-02-10","2021-01-07","2021-01-07","2021-01-07","2023-02-10","2021-09-28","2023-01-31","2021-09-28","2021-09-28","2021-09-28","2022-07-13","2023-02-10","2022-08-16","2022-07-13","2023-01-18","2022-07-13","2023-02-02","2022-10-20","2022-10-20","2021-03-17","2023-01-18","2022-01-20","2022-01-20","2022-03-29","2023-01-31","2023-01-31","2022-07-15","2023-01-18","2023-01-18","2023-01-18","2023-01-18","2023-01-18","2023-02-28","2023-02-28","2023-02-02","2022-08-16","2021-02-10","2021-02-10","2021-02-10","2021-02-10","2022-07-12","2022-07-11","2022-07-11","2022-11-16","2021-09-28","2022-07-20","2022-08-31","2022-08-31","2021-03-05","2021-12-29","2021-12-29","2021-12-29","2021-12-29","2021-12-29","2021-12-29","2021-12-29","2021-12-29","2021-02-05","2021-02-05","2021-02-05","2021-02-05","2021-02-05","2021-02-05","2021-02-05","2021-02-05","2021-02-05","2021-10-08"],"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":[["","16729009416","MYCOPHENOLAT","CAP 250MG","180","Select","Select",""],["","68992307501","ENVARSUS XR","0.75 MG","60","Select","Select",""],["","69315011610","FUROSEMIDE","20 MG","90","Select","Select",""],["","16729044015","CINACALCET","TAB 30MG","30","Select","Select",""],["","00054472825","PREDNISONE","5 MG","30","Select","Select",""],["","30768029173","VITAMIN D3","CAP 5000UNIT","90","Select","Select",""],["","68180051303","LISINOPRIL","5 MG","90","Select","Select",""],["","68382009305","CARVEDILOL","6.25 MG","180","Select","Select",""],["","68180096703","LEVOTHYROXIN","TAB 75MCG","90","Select","Select",""],["","00781106105","ALPRAZOLAM","0.25 MG","15","Select","Select",""],["","69097041002","CINACALCET HCL","30 MG","30","Select","Select",""],["","00536440901","VITAMIN B-","6 100 MG","91","Select","Select",""],["","16729009416","MYCOPHENOLATE MOFETIL","250 MG","180","Select","Select",""],["","65162047810","NITROFURANTOIN MONO-MACRO","100 MG","14","Select","Select",""],["","00093100301","BUSPIRONE HCL","15 MG","180","Select","Select",""],["","10135014501","PYRIDOXINE HCL","100 MG","91","Select","Select",""],["","30768029173","VITAMIN D","3 125 MCG","90","Select","Select",""],["","00169477212","OZEMPIC","2MG\/0.75ML","9","Select","Select",""],["","70700015010","OMEPRAZOLE","20 MG","180","Select","Select",""],["","68180096703","LEVOTHYROXINE SODIUM","75 MCG","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":""}]}]}