{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CAROLYN  M JEFFERSON","gend":1,"add":"49 J BROWN DR","city":"CHASE CITY","state":"VA","zip":"23924-9998","dob":"1962-08-10","age":"","mstatus":"","insh":"20029858*01","cliId":"","pno":4345333179,"cno":4345333179,"email":"","ename":"","eno":"","pphy":"POWERS III, GRAHAM H MD","ppno":4345842025,"pcpadd":"514 W ATLANTIC ST","pcpcity":"SOUTH HILL","pcpstate":"VA","pcpzip":"23970-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4344472240,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","E11.40","G80.8","E78.2","G40.A09","H91.90","L72.3","R94.6","M65.341","M19.90","M62.81","R94.01","R56.9","G80.2","I69.351","Z68.28","S63.91XA","M10.09","M05.79","M65.841","M79.642","G56.03","M79.643","M25.539","Z23.","E78.5","R55.","F17.210","I69.951","M71.339","R07.81","Z13.31","Z68.31","H25.13","E11.9","H35.033","H43.813","G56.01","M79.641","Y92.89","G81.91","Z79.899","M10.9","Z72.0","M10.042","Z76.89","D84.9","F17.200","M06.9","R79.89","Z79.620"],"date":["2022-11-29","2022-11-29","2021-04-23","2022-11-29","2021-04-23","2021-04-23","2021-04-23","2021-04-23","2021-09-26","2021-09-26","2021-09-26","2021-08-23","2021-08-23","2022-11-29","2022-11-29","2022-08-23","2022-04-07","2023-01-25","2023-04-04","2023-04-04","2022-01-25","2022-01-25","2022-04-07","2022-04-07","2022-11-29","2021-09-20","2021-09-20","2021-09-20","2021-01-12","2021-01-12","2021-01-12","2021-01-12","2021-01-12","2022-11-02","2022-11-02","2022-11-02","2022-11-02","2022-01-24","2022-02-23","2022-04-07","2022-10-07","2023-04-04","2023-04-04","2022-10-19","2022-10-14","2022-10-14","2022-11-29","2022-11-29","2022-11-29","2022-11-29","2022-11-29"],"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":[["","65162083909","VALSARTAN","160 MG","30","Select","Select",""],["","51991081801","PROPRANOLOL","CAP 80MG ER","90","Select","Select",""],["","70377002711","ATORVASTATIN","TAB 10MG","90","Select","Select",""],["","65862098601","POT CHLORIDE","TAB 8MEQ ER","180","Select","Select",""],["","67877056110","METFORMIN","TAB 500MG","30","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","4","Select","Select",""],["","53885024450","ONETOUCH","TES ULTRA","50","Select","Select",""],["","80777027399","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","43547022215","LEVETIRACETA","TAB 500MG","180","Select","Select",""],["","59746017509","PREDNISONE","20 MG","9","Select","Select",""],["","49483060450","IBUPROFEN","800 MG","42","Select","Select",""],["","43598072101","HYDROXYCHLOR","TAB 200MG","60","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","49884017101","COLCHICINE","0.6 MG","7","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","21","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","62332014231","CELECOXIB","CAP 200MG","30","Select","Select",""],["","00536589488","NICOTINE TD","DIS 7MG\/24HR","28","Select","Select",""],["","69315012710","FOLIC ACID","1 MG","30","Select","Select",""],["","51991081801","PROPRANOLOL HCL ER","80 MG","90","Select","Select",""],["","53885024450","ONETOUCH ULTRA TEST STRIP","","50","Select","Select",""],["","69097052444","DICLOFENAC SODIUM","1 %","100","Select","Select",""],["","00536589488","NICOTINE PATCH","7MG\/24HR","28","Select","Select",""],["","43547022215","LEVETIRACETAM","500 MG","180","Select","Select",""],["","43598072101","HYDROXYCHLOROQUINE SULFATE","200 MG","60","Select","Select",""],["","00832105515","BACLOFEN","20 MG","14","Select","Select",""],["","00378001401","METHOTREXATE","2.5 MG","72","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","67877019805","AMLODIPINE BESYLATE","5 MG","90","Select","Select",""],["","70377002711","ATORVASTATIN CALCIUM","10 MG","90","Select","Select",""],["","65862098601","POTASSIUM CHLORIDE","8 MEQ","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":""}]}]}