{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAMMY J YOUNG","gend":1,"add":"2174 EASLEY CROSSING TRL","city":"SCOTTSBURG","state":"VA","zip":"24589-9998","dob":"1976-08-02","age":"","mstatus":"","insh":"20038048*01","cliId":"","pno":4344700435,"cno":4344700435,"email":"","ename":"","eno":"","pphy":"LYONS, ELIZABETH A MD","ppno":4349242472,"pcpadd":"415 RAY C HUNT DR STE 2100,","pcpcity":"CHARLOTTESVILLE","pcpstate":"VA","pcpzip":"22903-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4349248179,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["U07.1","M25.611","M75.01","G89.29","I69.351","H21.233","I87.1","H04.123","M25.511","E87.6","D68.59","I85.00","D64.9","Z95.820","Z86.718","Z86.73","K58.9","I49.8","G93.2","N25.89","T50.2X5A","K21.9","Z86.16","E55.9","R42.","G54.0","E87.2","G89.4","D68.9","L40.50","M32.19","R51.9","R06.00","L65.9","R06.09","T82.856A","Z71.89","J30.9","I95.0","K58.0","I82.A11","I82.B11","R91.1","S49.92XA","M25.512","M79.2","G90.511","V58.89","R20.0","R20.2","J30.89","I82.90","S46.912A","W01.0XXA","S43.002A","G89.11","NO DATA","I82.B21","E61.1","N18.2","M32.9","N18.9","D63.1","I82.211","Z95.828","M75.81","J01.90","Z20.828","S46.012A","Z51.81","R29.898","M62.838","Z79.01","R60.0","I82.210","R05.","R53.83","M79.601","M62.81","R76.8","M25.50","Z01.818","M24.50","G90.519","Z84.89","I73.9","S49.91XD","Z45.2","F43.9","Z60.8","R25.2","K58.2","J06.9","G43.009","G43.809","R53.1","R93.6","Z20.822","Z86.010","Z83.79","R07.89","M94.0","M75.02","M24.112","G90.512","Z00.00","S22.32XA","Z12.31","Z23.","V54.19","Z78.0","M85.88","Z01.00","R30.0","R05.9","Z11.59","R10.13","N89.8","N81.10","I82.A21","M79.603","R13.10","K22.4","K25.9","K31.9","K31.89","N81.6","K59.09","N95.2","K58.1"],"date":["2021-03-05","2021-03-16","2022-10-21","2023-07-13","2021-03-16","2021-04-16","2023-07-19","2021-04-16","2022-11-22","2023-05-01","2021-06-29","2021-06-29","2023-01-30","2021-06-29","2023-07-13","2022-01-06","2021-06-29","2022-01-07","2023-06-09","2023-05-01","2021-06-29","2022-01-07","2021-09-28","2021-06-29","2021-06-29","2022-04-07","2022-06-02","2022-01-06","2022-01-07","2022-04-07","2023-05-24","2023-05-24","2023-04-20","2021-09-28","2021-09-28","2021-10-13","2022-01-14","2022-02-01","2023-05-01","2023-07-18","2022-02-15","2022-02-15","2022-02-15","2022-10-21","2023-07-13","2023-07-13","2021-05-11","2021-10-13","2022-10-27","2022-10-27","2022-02-01","2023-07-18","2022-10-11","2022-10-11","2022-10-13","2022-10-13","2023-05-01","2023-07-12","2023-01-30","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-08-25","2023-07-13","2023-04-11","2022-09-01","2022-09-01","2022-10-14","2023-04-11","2022-04-07","2021-04-06","2023-04-11","2021-10-07","2022-01-07","2021-03-05","2021-03-05","2021-05-19","2022-02-15","2023-01-31","2021-09-14","2021-09-14","2022-01-07","2022-01-07","2022-01-07","2022-10-27","2021-06-21","2021-06-22","2022-01-14","2022-01-14","2022-04-07","2023-07-18","2021-01-02","2022-10-27","2023-04-11","2021-02-19","2021-02-19","2021-06-29","2023-07-18","2023-07-18","2023-07-12","2023-04-11","2023-04-11","2023-04-11","2023-04-11","2023-05-01","2023-05-01","2023-05-01","2023-05-01","2023-06-09","2023-06-09","2023-06-09","2023-06-09","2023-06-09","2023-04-01","2023-05-24","2023-08-07","2023-07-19","2023-08-17","2023-07-12","2023-07-12","2023-08-07","2023-08-07","2023-08-07","2023-08-07","2023-08-07","2023-08-17","2023-08-17","2023-08-17","2023-08-17"],"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":[["","64380083406","ACETAZOLAMID","TAB 250MG","360","Select","Select",""],["","55150023210","FONDAPARINUX","INJ 7.5\/0.6","18","Select","Select",""],["","00591079501","DICYCLOMINE","TAB 20MG","60","Select","Select",""],["","00093819201","CIMETIDINE","TAB 300MG","120","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","14","Select","Select",""],["","62037099901","POT CL MICRO","TAB 20MEQ ER","360","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","31722088490","ROSUVASTATIN","TAB 20MG","30","Select","Select",""],["","11534016503","FOLIC ACID","1 MG","30","Select","Select",""],["","00378668977","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","65162010250","GABAPENTIN","CAP 300MG","100","Select","Select",""],["","65862035705","CLOPIDOGREL","75 MG","90","Select","Select",""],["","00591352530","LIDOCAINE","5 %","30","Select","Select",""],["","63824000832","MUCINEX","TAB 600MG ER","180","Select","Select",""],["","69097068105","PREGABALIN","100 MG","120","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00121067616","K CITRATE","SOL CITR ACD","3600","Select","Select",""],["","69238145902","POT CHLORIDE","SOL 0.1","450","Select","Select",""],["","45802086803","POLYETH GLYC","POW 3350 NF","510","Select","Select",""],["","68382073701","MIDODRINE","TAB 2.5MG","180","Select","Select",""],["","00574029201","AMILORIDE","TAB 5MG","30","Select","Select",""],["","00121059516","SOD CITRATE","SOL CITR ACD","473","Select","Select",""],["","00904506860","MI-ACID GAS","CHW 80MG","120","Select","Select",""],["","57896079101","SIMETHICONE","CHW 80MG","120","Select","Select",""],["","27808023302","DOXYCYCL HYC","CAP 100MG","14","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","10","Select","Select",""],["","00002237711","EMGALITY","INJ 120MG\/ML","2","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","00245036030","KLOR-CON","PAK 20MEQ","30","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","25","Select","Select",""],["","00172572960","FAMOTIDINE","40 MG","30","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","5","Select","Select",""],["","00023649810","UBRELVY","TAB 50MG","9","Select","Select",""],["","72618300002","NURTEC","TAB 75MG ODT","12","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","60505132001","MIDODRINE HCL","2.5 MG","180","Select","Select",""],["","00574029201","AMILORIDE HCL","5 MG","30","Select","Select",""],["","00527128201","DICYCLOMINE HCL","20 MG","10","Select","Select",""],["","64380083406","ACETAZOLAMIDE","250 MG","360","Select","Select",""],["","43386035610","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","5","Select","Select",""],["","55111068002","FONDAPARINUX SODIUM","7.5MG\/0.6","18","Select","Select",""],["","00378456105","POTASSIUM CHLORIDE","10 MEQ","720","Select","Select",""],["","72618300002","NURTEC ODT","75 MG","12","Select","Select",""],["","00002143611","EMGALITY PEN","120 MG\/ML","1","Select","Select",""],["","31722088490","ROSUVASTATIN CALCIUM","20 MG","90","Select","Select",""],["","00378668977","PANTOPRAZOLE SODIUM","40 MG","90","Select","Select",""],["","00121059516","SODIUM CITRATE-CITRIC ACID","334-500MG","473","Select","Select",""],["","00002143611","EMGALITY INJ","120MG\/ML","2","Select","Select",""],["","11534016503","FOLIC ACID TAB","1MG","30","Select","Select",""],["","45802086803","POLYETH GLYC POW","3350 NF","510","Select","Select",""],["","00574029201","AMILORIDE TAB","5MG","30","Select","Select",""],["","00591352530","LIDOCAINE PAD","5%","30","Select","Select",""],["","64380083406","ACETAZOLAMID TAB","250MG","360","Select","Select",""],["","00591079501","DICYCLOMINE TAB","20MG","60","Select","Select",""],["","00121059516","SOD CITRATE SOL CITR ACD","","473","Select","Select",""],["","68382073701","MIDODRINE TAB","2.5MG","180","Select","Select",""],["","68382032001","POT CHLORIDE TAB","10MEQ ER","720","Select","Select",""],["","00378668977","PANTOPRAZOLE TAB","40MG","90","Select","Select",""],["","55150023210","FONDAPARINUX INJ","7.5\/0.6","18","Select","Select",""],["","31722088490","ROSUVASTATIN TAB","20MG","90","Select","Select",""],["","00245036030","KLOR-CON PAK","20MEQ","30","Select","Select",""],["","65862035705","CLOPIDOGREL TAB","75MG","90","Select","Select",""],["","69097068105","PREGABALIN CAP","100MG","90","Select","Select",""],["","69238145902","POT CHLORIDE SOL","10%","450","Select","Select",""],["","00093819201","CIMETIDINE TAB","300MG","120","Select","Select",""],["","00172572960","FAMOTIDINE TAB","40MG","30","Select","Select",""],["","00406055201","OXYCODONE TAB","5MG","25","Select","Select",""],["","27808023302","DOXYCYCL HYC CAP","100MG","14","Select","Select",""],["","70010075401","METHOCARBAM TAB","500MG","40","Select","Select",""],["","72618300002","NURTEC TAB","75MG ODT","12","Select","Select",""],["","00406012305","HYDROCO\/APAP TAB","5-325MG","5","Select","Select",""],["","00023649810","UBRELVY TAB","50MG","10","Select","Select",""],["","16571020210","DICLOFENAC TAB","50MG DR","14","Select","Select",""],["","70010075401","METHOCARBAMOL","500 MG","90","Select","Select",""],["","65162006205","SUCRALFATE","1 G\/10 ML","1200","Select","Select",""],["","47781010444","ESTRADIOL","0.01 %","42.5","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":""}]}]}