{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIMMORA L BOYD","gend":1,"add":"606 SANDUSKY DR APT 21D","city":"LYNCHBURG","state":"VA","zip":"24502-9998","dob":"1980-11-02","age":"","mstatus":"","insh":"20024233*01","cliId":"","pno":4345095692,"cno":4345095692,"email":"","ename":"","eno":"","pphy":"PETERS, TAWNYA NP","ppno":4342003366,"pcpadd":"800 5TH STREET,","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":"24504-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4342003106,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.1","M79.673","E11.42","E11.65","E78.5","NO DATA","U07.1","R07.89","R05.9","F31.9","M79.671","R26.2","M62.81","M76.821","M76.71","M76.61","M72.2","I10.","G89.4","Z79.899","E11.8","N28.9","R20.2","R63.4","G89.29","J02.9","R68.83","R11.2","E11.9","Z20.822","E11.40","M79.604","M79.605","E11.22","N18.9","Z00.01","M51.36","G62.9","M79.641","F17.210","E11.69","D64.9","Z86.59"],"date":["2021-04-23","2022-01-06","2022-11-21","2022-04-25","2023-09-07","2023-09-07","2023-01-05","2023-01-05","2023-01-05","2023-01-05","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-25","2023-02-27","2023-02-27","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2021-02-28","2021-02-28","2021-02-28","2021-02-28","2021-02-28","2022-11-22","2022-11-15","2022-11-15","2022-11-15","2022-11-15","2021-03-04","2023-09-07","2023-09-07","2023-09-07","2023-09-07","2023-09-07","2023-09-07","2023-09-07"],"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":[["","99073013001","FREESTYLE","MIS LANCETS","100","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","30","Select","Select",""],["","45963055650","GABAPENTIN","300 MG","14","Select","Select",""],["","56151146003","TRUE METRIX","TES GLUCOSE","25","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","15","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","65862020199","LOSARTAN POT","TAB 25MG","90","Select","Select",""],["","00006011231","JANUVIA","TAB 50MG","30","Select","Select",""],["","00069034530","PAXLOVID (EUA)","300-100 MG","30","Select","Select",""],["","68382005105","MELOXICAM TAB","15MG","30","Select","Select",""],["","64380080807","IBUPROFEN TAB","600MG","15","Select","Select",""],["","00406012305","HYDROCO\/APAP TAB","5-325MG","12","Select","Select",""],["","99073071143","FREESTYLE KIT INSULINX","","1","Select","Select",""],["","99073013001","FREESTYLE MIS LANCETS","","100","Select","Select",""],["","99073070822","FREESTYLE TES LITE","","50","Select","Select",""],["","99073071231","FREESTYLE TES INSULINX","","50","Select","Select",""],["","99073070805","FREESTYLE KIT LITE","","1","Select","Select",""],["","56151146003","TRUE METRIX TES GLUCOSE","","25","Select","Select",""],["","45963055650","GABAPENTIN CAP","300MG","90","Select","Select",""],["","65862020199","LOSARTAN POT TAB","25MG","90","Select","Select",""],["","00006011231","JANUVIA TAB","50MG","30","Select","Select",""],["","00363017508","PAIN RELIEVER","500 MG","60","Select","Select",""],["","00406012305","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","5","Select","Select",""],["","72888001001","BACLOFEN","10 MG","30","Select","Select",""],["","29300042010","AMITRIPTYLINE HCL","25 MG","90","Select","Select",""],["","65862001105","SERTRALINE HCL","25 MG","180","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":""}]}]}