{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TIFFANY M JONES","gend":1,"add":"6430 ESMONT RD","city":"KEENE","state":"VA","zip":"22946-9998","dob":"1969-06-05","age":"","mstatus":"","insh":"20030367*01","cliId":"","pno":4342862341,"cno":4342862341,"email":"","ename":"","eno":"","pphy":"STREETER, GREGORY MD","ppno":4342436868,"pcpadd":"1221 LEE ST,","pcpcity":"CHARLOTTESVILLE","pcpstate":"VA","pcpzip":"22908-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4342432916,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K43.6","Z59.0","J96.00","E87.2","Z48.1","E46.","D50.9","Z48.815","K86.0","Z43.3","F10.20","E43.","R26.2","R53.1","NO DATA","K21.9","Z79.899","Z79.2","Z98.0","Z90.49","Z87.442","Z87.11","Z68.20","R00.0","D64.9","K94.09","K59.09","F17.200","F10.10","R10.9","Z30.42","Z01.810","Z30.8","Z12.31","Z12.11","J30.2","M25.561","Z72.0","Z60.8","R52.","R10.84","E80.6","K43.5","K43.3","K86.1","G89.18","K66.0","F17.210","Z83.3","Z82.0","Z81.8","Z80.9","Z88.6","Z98.890","Z87.19","M17.11","M79.604","R19.7","Z32.02","Z93.3","K63.1","K65.1","K55.049","J96.01","K43.0","F19.10","D63.8","Z88.0","Z88.1","A41.9","R65.21","E87.79","D62.","E87.8","E63.9","R10.31","R10.11","Z20.822","L08.9","R25.1","F10.129","R56.9","K55.041","Z87.898","E44.1","S82.62XA","W01.0XXA","S82.832A","M25.572","M79.662","V54.16","M79.605"],"date":["2021-09-20","2021-09-01","2021-09-03","2021-09-02","2021-09-10","2021-10-25","2021-12-08","2021-12-08","2021-12-08","2022-07-23","2021-12-08","2021-12-08","2021-12-08","2021-12-08","2022-03-01","2022-03-02","2022-03-02","2021-12-08","2021-12-08","2022-03-02","2022-03-02","2022-03-02","2021-12-08","2021-11-22","2021-11-22","2022-03-04","2021-12-08","2021-12-08","2022-03-02","2022-03-01","2023-09-21","2022-03-05","2023-09-21","2023-02-01","2023-02-01","2023-02-01","2023-02-01","2022-01-15","2022-01-10","2023-08-03","2022-03-07","2021-09-10","2022-03-02","2022-03-02","2022-03-02","2022-03-07","2022-03-02","2023-08-03","2022-03-02","2022-03-02","2022-03-02","2022-03-02","2022-03-02","2022-05-02","2022-05-02","2022-12-28","2022-12-28","2021-12-08","2021-11-12","2022-02-21","2021-09-01","2021-09-01","2021-09-01","2021-09-07","2021-09-01","2021-09-01","2021-09-01","2021-09-01","2021-09-01","2021-09-07","2021-09-07","2021-09-07","2021-09-07","2021-09-07","2021-09-07","2022-03-01","2022-03-01","2022-03-01","2022-03-04","2021-08-05","2021-08-05","2021-08-05","2021-09-01","2021-09-01","2021-09-07","2023-08-22","2023-07-25","2023-08-22","2023-08-22","2023-08-03","2023-08-22","2023-08-03"],"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":[["","69842087651","CVS ACETAMIN","TAB 325MG","30","Select","Select",""],["","49483034010","ACETAMIN","TAB 325MG","30","Select","Select",""],["","65862050320","AMOX\/K CLAV","TAB 875-125","28","Select","Select",""],["","00245010810","FERROUS SULF","TAB 325MG EC","270","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","15","Select","Select",""],["","43386009019","GAVILYTE-G","236-22.74G","4000","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","10702001801","OXYCODONE TAB","5MG","15","Select","Select",""],["","10702001801","OXYCODONE HCL","5 MG","15","Select","Select",""],["","16571020110","DICLOFENAC SODIUM","75 MG","30","Select","Select",""],["","00093216568","NALOXONE HCL","4 MG","2","Select","Select",""],["","49483034010","ACETAMINOPHEN","325 MG","80","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":""}]}]}