{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHRISTINE J KING","gend":1,"add":"612 GRADY ST APT E","city":"LYNCHBURG","state":"VA","zip":"24501-9998","dob":"1973-05-05","age":"","mstatus":"","insh":"20030636*01","cliId":"","pno":4345687658,"cno":4345687658,"email":"","ename":"","eno":"","pphy":"HAHESY-CALHOUN, MARIAN MD","ppno":4345425560,"pcpadd":"165 LEGRANDE AVENUE,","pcpcity":"CHARLOTTE COURT HOUSE","pcpstate":"VA","pcpzip":"23923-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4345424670,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M76.821","Z98.1","M25.571","M62.81","M79.604","M50.30","M47.892","M48.02","E11.8","E66.9","D25.9","M54.2","M54.5","M25.512","R60.9","E11.9","G47.33","K21.9","Z87.891","Z79.82","Z79.899","NO DATA","M19.072","Z20.828","D25.1","N95.1","N94.10","R23.2","R61.","M47.816","G89.4","I10.","Z79.84","V58.89","M19.071","M54.12","G47.30","R06.83","G47.10","R13.10","Z12.11","Z71.9","R42.","M51.36","M43.16","R22.1","H81.10","R10.30","R10.2","M54.17","H60.392","R10.31","S29.012A","X50.0XXA","Y92.89","R60.0","M79.89","R22.2","M50.10","M47.812","M51.34","M79.602","M79.641","M79.642","R20.2","Z71.89","Z71.3","Z68.43","M41.56","E66.01","M11.9","N30.90","N39.0","S61.210A","W23.0XXA","S67.21XA","I12.9","N18.2","N28.1","N25.81","E66.3","R10.84","R52.","L03.012","M41.86","N92.0","E78.2","E89.0","M25.551","J30.9","G43.909","M47.9","M54.16","M47.819","M48.00","M79.651","S39.012A","S70.02XA","S30.1XXA","V89.2XXA","Y92.410","N18.1","K59.00","M54.9","M43.12","G89.29","Z23.","J98.8","J03.80","J03.91","R13.19","J03.90","J30.0","S50.11XA","J31.0","M25.561","F17.210","W19.XXXA","Y93.01","R31.0","K22.2","J30.2","M79.672","M25.562"],"date":["2021-01-04","2023-07-03","2023-09-18","2022-02-03","2021-03-16","2022-09-28","2021-03-03","2021-10-28","2022-09-28","2021-10-28","2021-10-21","2023-06-28","2021-08-18","2021-08-18","2021-09-24","2023-07-20","2023-07-20","2023-07-20","2021-09-24","2021-09-24","2021-09-24","2023-07-24","2022-02-24","2022-05-31","2023-07-24","2022-10-18","2023-07-24","2022-10-18","2022-10-18","2023-05-18","2023-06-28","2023-05-18","2023-05-18","2023-05-22","2023-09-18","2021-06-17","2023-07-20","2022-04-03","2022-04-03","2023-09-05","2022-08-05","2022-08-05","2021-02-24","2023-05-03","2022-09-28","2022-01-23","2022-01-23","2021-05-14","2023-07-24","2021-05-14","2021-05-14","2021-07-12","2021-07-15","2021-07-15","2021-07-15","2021-09-24","2021-09-24","2021-09-24","2021-10-28","2023-06-28","2022-09-28","2021-05-20","2023-04-12","2021-03-03","2021-03-03","2022-03-09","2022-03-09","2022-03-09","2022-08-30","2022-09-28","2022-08-30","2023-01-06","2023-01-06","2023-02-22","2023-02-22","2023-04-12","2023-05-09","2023-05-09","2023-05-09","2023-05-09","2023-07-20","2021-04-15","2021-04-15","2021-06-21","2022-09-28","2022-10-18","2021-06-29","2021-06-29","2021-06-29","2021-06-29","2021-06-29","2023-05-03","2023-07-03","2023-05-03","2023-05-03","2021-01-07","2021-10-04","2021-10-04","2021-10-04","2021-10-04","2021-10-04","2021-12-22","2021-12-22","2021-10-28","2021-10-28","2023-09-18","2021-11-19","2022-06-07","2022-06-07","2023-06-27","2023-06-27","2023-06-27","2023-07-18","2023-02-22","2023-06-19","2023-09-18","2023-07-20","2023-07-20","2023-07-20","2023-07-24","2023-09-05","2023-07-18","2023-09-18","2023-09-18"],"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":[["","59779060027","CVS ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","69097012203","TOPIRAMATE","25 MG","114","Select","Select",""],["","43547040111","FUROSEMIDE","20 MG","30","Select","Select",""],["","53885099425","ONETOUCH","TES ULTRA","25","Select","Select",""],["","68180051201","LISINOPRIL","2.5 MG","30","Select","Select",""],["","60505025203","TIZANIDINE","TAB 4MG","90","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","70010049110","METFORMIN","TAB 500MG ER","30","Select","Select",""],["","68462030450","NORETHIN ACE","TAB 5MG","90","Select","Select",""],["","00093005805","TRAMADOL HCL","50 MG","60","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","45802065078","LORATADINE","10 MG","30","Select","Select",""],["","59779030603","CVS PURELAX","POW ","510","Select","Select",""],["","00093081201","NORTRIPTYLIN","CAP 50MG","30","Select","Select",""],["","49483048112","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","43386031214","GAVILAX","POW ","510","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","10","Select","Select",""],["","70000041503","CLEARLAX","POW ","510","Select","Select",""],["","00054001729","PREDNISONE","TAB 10MG","6","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","11523723404","MIRALAX","POW 3350 NF","510","Select","Select",""],["","53885039310","ONETOUCH US","MIS LANCETS","100","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","51672203506","MICONAZOLE","CRE 0.02","45","Select","Select",""],["","43598029390","PREGABALIN","75 MG","60","Select","Select",""],["","00904674880","BISACODYL","TAB 5MG EC","2","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","20","Select","Select",""],["","69452015120","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","45802086803","POLYETH GLYC","POW 3350 NF","510","Select","Select",""],["","69097012210",""," ","60","Select","Select",""],["","00536100410","ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","53885099425","ONETOUCH ULTRA TEST STRIP","","25","Select","Select",""],["","72578009721","TIZANIDINE HCL","4 MG","90","Select","Select",""],["","00378668910","PANTOPRAZOLE SODIUM","40 MG","30","Select","Select",""],["","68462030450","NORETHINDRONE ACETATE","5 MG","30","Select","Select",""],["","69097052444","DICLOFENAC SODIUM","1 %","100","Select","Select",""],["","75826011510","PHENAZOPYRIDINE HCL","200 MG","6","Select","Select",""],["","00093081201","NORTRIPTYLINE HCL","50 MG","30","Select","Select",""],["","49483048112","ASPIRIN EC","81 MG","30","Select","Select",""],["","70010049110","METFORMIN HCL ER","500 MG","90","Select","Select",""],["","53885039310","ONETOUCH LANCETS","","100","Select","Select",""],["","68180012202","CEPHALEXIN","500 MG","10","Select","Select",""],["","71384070021","KETAMINE HCL","100 MG","30","Select","Select",""],["","59779060027","CVS ASPIRIN TAB","81MG EC","30","Select","Select",""],["","68180051201","LISINOPRIL TAB","2.5MG","30","Select","Select",""],["","60505025203","TIZANIDINE TAB","4MG","90","Select","Select",""],["","16571020106","DICLOFENAC TAB","75MG DR","60","Select","Select",""],["","51672400302","NORTRIPTYLIN CAP","50MG","30","Select","Select",""],["","70010049110","METFORMIN TAB","500MG ER","30","Select","Select",""],["","00093005805","TRAMADOL HCL TAB","50MG","56","Select","Select",""],["","57896098112","ASPIRIN LOW TAB","81MG EC","30","Select","Select",""],["","69097012203","TOPIRAMATE TAB","25MG","60","Select","Select",""],["","43547040111","FUROSEMIDE TAB","20MG","30","Select","Select",""],["","53885099425","ONETOUCH TES ULTRA","","25","Select","Select",""],["","68462030450","NORETHIN ACE TAB","5MG","90","Select","Select",""],["","45802065087","LORATADINE TAB","10MG","30","Select","Select",""],["","59779030603","CVS PURELAX POW","","510","Select","Select",""],["","00378668910","PANTOPRAZOLE TAB","40MG","30","Select","Select",""],["","00603188016","LIDOCAINE PAD","5%","10","Select","Select",""],["","43386031214","GAVILAX POW","","510","Select","Select",""],["","36800030603","CLEARLAX POW","","510","Select","Select",""],["","41100082071","MIRALAX POW","3350 NF","510","Select","Select",""],["","65862001501","AMOXICILLIN TAB","875MG","20","Select","Select",""],["","43598029290","PREGABALIN CAP","50MG","60","Select","Select",""],["","00054001729","PREDNISONE TAB","10MG","6","Select","Select",""],["","00904674880","BISACODYL TAB","5MG EC","2","Select","Select",""],["","53885039310","ONETOUCH US MIS LANCETS","","100","Select","Select",""],["","57237000511","FLUCONAZOLE TAB","150MG","1","Select","Select",""],["","51672203506","MICONAZOLE CRE","2%","45","Select","Select",""],["","45802086803","POLYETH GLYC POW","3350 NF","510","Select","Select",""],["","00536100410","ASPIRIN TAB","81MG EC","30","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","4","Select","Select",""],["","47781030301","NITROFURANTN CAP","100MG","20","Select","Select",""],["","00093216568","NALOXONE HCL","4 MG","2","Select","Select",""],["","51672130406","TERCONAZOLE","0.4 %","45","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","24208039915","IPRATROPIUM BROMIDE","42 MCG","15","Select","Select",""],["","59651021430","AZELASTINE HCL","137 MCG","30","Select","Select",""],["","65862050320","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","20","Select","Select",""],["","65162019050","NAPROXEN","500 MG","20","Select","Select",""],["","53885027810","ONETOUCH ULTRASOFT","2 LANCET 30 GAUGE","100","Select","Select",""],["","70461032303","FLUCELVAX QUAD","2023-2024 60MCG\/.5ML","0.5","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":""}]}]}