{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VICTORIA L JENKINS","gend":1,"add":"2178 BEAVER POND ROAD","city":"NATHALIE","state":"VA","zip":"24577-9998","dob":"1989-03-26","age":"","mstatus":"","insh":"20051925*01","cliId":"","pno":4344460593,"cno":4344460593,"email":"","ename":"","eno":"","pphy":"LE, UYEN MD","ppno":4345728921,"pcpadd":"1020 BILL TUCK HWY STE 900,","pcpcity":"SOUTH BOSTON","pcpstate":"VA","pcpzip":"24592-9998","pcpcounty":"","pcpid":"","pcpname":"Fuller-Roberts OB\/GYN & Primary Care","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4345751290,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","M79.604","M79.605","R60.0","I87.1","J02.9","Z20.828","I70.202","L03.119","I87.2","D72.829","E66.01","Z20.822","R07.89","R06.02","R00.2","Z13.6","Z68.42","Z30.013","I73.9","I27.20","R07.9","N91.2","J01.90","I27.21","Z20.818","R05.1","I70.222","F41.8","G45.9","I87.8","L03.115","L03.116","U07.1","R43.0","R11.2","F17.210","Z82.61","Z83.49","Z80.3","Z83.3","Z88.0","Z91.030","R10.13","O98.511","O03.9","Z3A.00","R53.83","M79.7","E55.9","I73.00","NO DATA","K12.2","R11.0","J30.9","L03.315","R06.00","F17.200","R50.9","R51.9","R30.0","J06.9"],"date":["2023-08-31","2022-05-05","2022-05-05","2022-05-05","2022-05-05","2023-01-22","2023-05-03","2021-04-22","2021-07-15","2021-07-15","2021-07-15","2021-07-15","2021-03-18","2021-04-16","2021-07-15","2021-04-16","2021-03-19","2021-03-19","2021-05-17","2021-05-20","2021-07-15","2021-07-15","2022-07-21","2022-12-03","2021-07-06","2023-03-07","2023-05-03","2021-04-22","2021-05-14","2021-06-15","2021-06-28","2021-06-28","2021-06-28","2022-07-11","2021-12-21","2022-05-11","2022-11-07","2022-05-11","2022-05-11","2022-05-11","2022-05-11","2022-05-11","2022-05-11","2022-05-11","2022-07-11","2022-07-11","2022-07-11","2022-07-28","2022-02-11","2022-02-11","2022-02-11","2021-07-15","2022-06-25","2022-09-22","2021-03-30","2021-03-30","2021-04-16","2021-04-16","2022-05-11","2022-09-22","2022-10-24","2023-05-03"],"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":[["","12496120803","SUBOXONE","8 MG-2 MG","60","Select","Select",""],["","47781035703","BUPREN\/NALOX","MIS 8-2MG","60","Select","Select",""],["","65862052305","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","59417010310","VYVANSE","30 MG","30","Select","Select",""],["","43547040211","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","66993037179","MEDROXYPR AC","INJ 150MG\/ML","1","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","00023650110","UBRELVY","100 MG","10","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","30","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","12","Select","Select",""],["","49035019602","EQ NICOTINE","DIS 7MG\/24HR","14","Select","Select",""],["","45802081184","NALOXONE HCL","4 MG","2","Select","Select",""],["","68180016106","AZITHROMYCIN","500 MG","3","Select","Select",""],["","47781035703","BUPRENORPHINE-NALOXONE","8 MG-2 MG","60","Select","Select",""],["","67877021905","CEPHALEXIN","500 MG","20","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","64679060416","PROMETHAZINE-DM","6.25-15\/5","168","Select","Select",""],["","12496120803","SUBOXONE MIS","8-2MG","60","Select","Select",""],["","47781035703","BUPREN\/NALOX MIS","8-2MG","60","Select","Select",""],["","65862052305","GABAPENTIN TAB","600MG","90","Select","Select",""],["","43547040211","FUROSEMIDE TAB","40MG","30","Select","Select",""],["","59417010310","VYVANSE CAP","30MG","30","Select","Select",""],["","68462010530","ONDANSETRON TAB","4MG","30","Select","Select",""],["","63304069301","CLINDAMYCIN CAP","300MG","21","Select","Select",""],["","66993037179","MEDROXYPR AC INJ","150MG\/ML","1","Select","Select",""],["","45802065078","LORATADINE TAB","10MG","30","Select","Select",""],["","00023650110","UBRELVY TAB","100MG","10","Select","Select",""],["","49483060450","IBUPROFEN TAB","800MG","12","Select","Select",""],["","68180016111","AZITHROMYCIN TAB","500MG","3","Select","Select",""],["","49035019602","EQ NICOTINE DIS","7MG\/24HR","14","Select","Select",""],["","00093216568","NALOXONE HCL SPR","4MG","2","Select","Select",""],["","51991036378","RIZATRIPTAN","10 MG","30","Select","Select",""],["","43547060410","LISDEXAMFETAMINE DIMESYLATE","30 MG","30","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":""}]}]}