{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TIMOTHY W HARGIS","gend":0,"add":"232 TWIN OAKS TERRACE","city":"RUSTBURG","state":"VA","zip":"24588-9998","dob":"1960-09-06","age":"","mstatus":"","insh":"2004266*01","cliId":"","pno":7572704176,"cno":7572704176,"email":"","ename":"","eno":"","pphy":"REESE, DAVID W PA","ppno":5404257910,"pcpadd":"582 BLUE RIDGE AVE,","pcpcity":"BEDFORD","pcpstate":"VA","pcpzip":"24523-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5405835149,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R78.81","B95.7","A49.02","J15.212","R57.0","J96.00","I21.3","I46.9","J90.","E11.9","N17.9","R13.10","I50.21","G93.40","R65.21","R14.0","E87.0","F41.9","Z78.1","I25.5","I25.10","B86.","I10.","E78.5","K42.0","R46.89","Z72.0","R79.89","E11.65","F17.200","E87.2","R77.8","Z51.5","Z71.89","I21.09","A41.1","G93.1","Z20.822","NO DATA","I11.0","Z48.812","I50.9","I95.9","K21.9","F17.210","F10.10","Z86.74","Z79.84","Z79.4","M25.40","R21.","F43.9","F05.","E88.09","L03.311","K94.23","R50.9","K42.9","G56.03","R07.89","R07.9","R40.20","R09.02","R06.89","E66.9","I21.29","I49.1","K30.","R73.9","Z79.899","G89.4","Z95.5","Z23."],"date":["2022-04-05","2022-02-18","2022-02-18","2022-02-18","2022-03-12","2022-03-12","2022-05-17","2023-01-30","2022-02-12","2023-05-12","2022-04-14","2022-03-12","2022-03-12","2022-03-14","2022-04-14","2022-03-12","2022-03-08","2022-05-17","2022-03-14","2023-01-30","2023-05-12","2022-07-27","2023-01-30","2023-08-11","2021-05-17","2022-01-24","2022-04-05","2022-02-05","2023-08-11","2022-05-17","2022-04-14","2022-01-31","2022-02-23","2022-02-23","2022-04-05","2022-03-08","2022-03-25","2022-03-08","2022-03-08","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-06-16","2022-04-14","2023-08-11","2022-06-16","2022-06-16","2021-02-03","2022-01-31","2022-01-31","2022-01-31","2022-03-03","2022-02-11","2021-05-17","2022-05-17","2022-01-30","2022-01-30","2022-01-30","2022-01-30","2022-01-30","2021-03-22","2022-01-30","2022-01-30","2022-01-30","2022-01-30","2022-01-30","2022-03-25","2022-05-17","2023-05-12"],"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":[["","00002318280","TRULICITY","4.5 MG\/0.5","6","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","12","Select","Select",""],["","62332002890","LOSARTAN POT","TAB 50MG","30","Select","Select",""],["","00378395377","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","00093321205","CLONAZEPAM","1 MG","30","Select","Select",""],["","00378111005","GLIPIZIDE","TAB 10MG","60","Select","Select",""],["","50111056102","TRAZODONE","TAB 100MG","30","Select","Select",""],["","81131000720","D3","CAP 2000UNIT","30","Select","Select",""],["","00093727256","PIOGLITAZONE","TAB 30MG","30","Select","Select",""],["","31722000490","VENLAFAXINE","CAP 150MG ER","30","Select","Select",""],["","51224000750","METFORMIN","TAB 500MG ER","120","Select","Select",""],["","57664037713","TRAMADOL HCL","TAB 50MG","30","Select","Select",""],["","00172208380","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","31604004071","D3 2000","TAB 2000UNIT","30","Select","Select",""],["","80681000900","VITAMIN D3","CAP 50MCG","30","Select","Select",""],["","60505024701","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","31722070930","SILDENAFIL","TAB 25MG","60","Select","Select",""],["","68382009810","PAROXETINE","TAB 20MG","30","Select","Select",""],["","49281072110","FLUBLOK QUAD","INJ 2021-22","0","Select","Select",""],["","00406117003","NALTREXONE","TAB 50MG","30","Select","Select",""],["","69315011601","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","57664050658","METOPROL TAR","TAB 25MG","60","Select","Select",""],["","65162010250","GABAPENTIN","300 MG","90","Select","Select",""],["","69097084615","CYCLOBENZAPR","TAB 10MG","90","Select","Select",""],["","16729027310","PRASUGREL","TAB 10MG","30","Select","Select",""],["","55111016330","OLANZAPINE","2.5 MG","90","Select","Select",""],["","55111011901","FAMOTIDINE","20 MG","60","Select","Select",""],["","68382009505","CARVEDILOL","25 MG","60","Select","Select",""],["","00597015330","JARDIANCE","25 MG","90","Select","Select",""],["","00310621030","FARXIGA","TAB 10MG","30","Select","Select",""],["","59762151501","CELECOXIB","CAP 50MG","60","Select","Select",""],["","72205000590","ROSUVASTATIN","TAB 40MG","30","Select","Select",""],["","00078065920","ENTRESTO","24 MG-26MG","60","Select","Select",""],["","40093014002","D3 HIGH POTE","CAP 50MCG","30","Select","Select",""],["","68180012101","CEPHALEXIN","CAP 250MG","24","Select","Select",""],["","69238110002","DOXYCYCL HYC","CAP 100MG","12","Select","Select",""],["","49348075707","SM ASPIRIN","CHW 81MG","30","Select","Select",""],["","49884015576","VARENICLINE","TAB 0.5MG","60","Select","Select",""],["","60505476505","APO-VARENICL","TAB 0.5MG","60","Select","Select",""],["","69097015807","MELOXICAM","7.5 MG","30","Select","Select",""],["","00904675180","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","00185067605","HYDROXYZ PAM","CAP 50MG","120","Select","Select",""],["","51672128402","TRIAMCINOLON","OIN 0.001","60","Select","Select",""],["","21922002107","PERMETHRIN","CRE 0.05","120","Select","Select",""],["","51079075920","ATENOLOL","TAB 25MG","30","Select","Select",""],["","59267030402","PFIZER BIVAL","INJ BA4\/BA5","0","Select","Select",""],["","49281042250","FLUZONE QUAD","INJ 2022-23","0","Select","Select",""],["","56151211201","PEN NEEDLES","MIS 31GX6MM","100","Select","Select",""],["","69097085907","TERBINAFINE","TAB 250MG","84","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","57896091136","ASPIRIN","81 MG","30","Select","Select",""],["","67877041301","METFORMIN HCL ER","500 MG","120","Select","Select",""],["","00088221905","LANTUS SOLOSTAR","100\/ML (3)","15","Select","Select",""],["","68462026405","ROSUVASTATIN CALCIUM","40 MG","90","Select","Select",""],["","49884015576","VARENICLINE TARTRATE","0.5 MG","60","Select","Select",""],["","57599080000","FREESTYLE LIBRE","2 SENSOR","6","Select","Select",""],["","00185067605","HYDROXYZINE PAMOATE","50 MG","120","Select","Select",""],["","80681000900","VITAMIN D","3 50 MCG","90","Select","Select",""],["","60505464303","PRASUGREL HCL","10 MG","30","Select","Select",""],["","56151211201","TRUEPLUS PEN NEEDLE","31 G X1\/4\"","100","Select","Select",""],["","69097085907","TERBINAFINE HCL","250 MG","24","Select","Select",""],["","72888001400","CYCLOBENZAPRINE HCL","10 MG","90","Select","Select",""],["","31722070110","LOSARTAN POT TAB","50MG","90","Select","Select",""],["","51224000750","METFORMIN TAB","500MG ER","120","Select","Select",""],["","00093727256","PIOGLITAZONE TAB","30MG","30","Select","Select",""],["","00378111005","GLIPIZIDE TAB","10MG","60","Select","Select",""],["","69238110002","DOXYCYCL HYC CAP","100MG","12","Select","Select",""],["","69097084615","CYCLOBENZAPR TAB","10MG","90","Select","Select",""],["","60505464303","PRASUGREL TAB","10MG","30","Select","Select",""],["","69315011601","FUROSEMIDE TAB","20MG","30","Select","Select",""],["","55111016330","OLANZAPINE TAB","2.5MG","30","Select","Select",""],["","57664050658","METOPROL TAR TAB","25MG","60","Select","Select",""],["","49348075707","SM ASPIRIN CHW","81MG","30","Select","Select",""],["","62332000131","FAMOTIDINE TAB","20MG","60","Select","Select",""],["","00093505798","ATORVASTATIN TAB","80MG","30","Select","Select",""],["","00597015290","JARDIANCE TAB","10MG","30","Select","Select",""],["","68382009505","CARVEDILOL TAB","25MG","60","Select","Select",""],["","00078065967","ENTRESTO TAB","24-26MG","60","Select","Select",""],["","60505476505","APO-VARENICL TAB","0.5MG","60","Select","Select",""],["","50228018010","GABAPENTIN CAP","300MG","90","Select","Select",""],["","00904675180","ASPIRIN LOW TAB","81MG EC","30","Select","Select",""],["","68180012101","CEPHALEXIN CAP","250MG","24","Select","Select",""],["","49884015576","VARENICLINE TAB","0.5MG","60","Select","Select",""],["","00093321205","CLONAZEPAM TAB","1MG","30","Select","Select",""],["","00310621030","FARXIGA TAB","10MG","30","Select","Select",""],["","00002223680","TRULICITY INJ","3\/0.5","2","Select","Select",""],["","40093014002","D","3 HIGH POTE CAP 50MCG","30","Select","Select",""],["","59762151501","CELECOXIB CAP","50MG","60","Select","Select",""],["","00172208380","HYDROCHLOROT TAB","25MG","30","Select","Select",""],["","69097015807","MELOXICAM TAB","7.5MG","30","Select","Select",""],["","51672128402","TRIAMCINOLON OIN","0.1%","60","Select","Select",""],["","21922002107","PERMETHRIN CRE","5%","120","Select","Select",""],["","51079075920","ATENOLOL TAB","25MG","30","Select","Select",""],["","50111056102","TRAZODONE TAB","100MG","30","Select","Select",""],["","72205000590","ROSUVASTATIN TAB","40MG","30","Select","Select",""],["","00185067605","HYDROXYZ PAM CAP","50MG","120","Select","Select",""],["","59267030402","PFIZER BIVAL INJ BA","4\/BA5","0","Select","Select",""],["","49281042250","FLUZONE QUAD INJ","2022-23","0","Select","Select",""],["","56151211201","PEN NEEDLES MIS","31GX6MM","100","Select","Select",""],["","00088221905","LANTUS SOLOS INJ","100\/ML","15","Select","Select",""],["","57896091136","ASPIRIN CHW","81MG","30","Select","Select",""],["","69097085907","TERBINAFINE TAB","250MG","84","Select","Select",""],["","00904675180","ASPIRIN EC","81 MG","30","Select","Select",""],["","50111056103","TRAZODONE HCL","100 MG","90","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":""}]}]}