{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"APRIL  D BILLER","gend":1,"add":"2890 HONEY RUN ROAD","city":"DAYTON","state":"VA","zip":"22821-9998","dob":"1971-02-09","age":"","mstatus":"","insh":"20059546*01","cliId":"","pno":5402718442,"cno":5402718442,"email":"","ename":"","eno":"","pphy":"RICE, GILBERT C DO","ppno":5402349241,"pcpadd":"1151 KEEZLETOWN RD SUITE 101,","pcpcity":"WEYERS CAVE","pcpstate":"VA","pcpzip":"24486-9998","pcpcounty":"","pcpid":"","pcpname":"Carilion Family Medicine - Weyers Cave","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5402349200,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M32.9","M35.00","K90.0","M79.7","E55.9","Z51.81","R00.2","R79.89","E66.01","Z68.41","D22.5","L82.1","L57.8","L82.0","Z20.822","K21.9","K58.0","Z01.419","R19.8","R10.9","R74.8","I10.","E78.5","F51.01","NO DATA","F41.9","G43.009","I49.1","I49.3","I34.1","E66.9","L85.3","Z79.899","F32.9","L98.9","Z23.","R68.89","Z12.11","Z68.39"],"date":["2022-12-06","2022-12-06","2022-12-06","2022-12-06","2022-12-06","2022-12-06","2021-07-13","2022-03-16","2023-07-18","2023-07-18","2021-12-13","2021-12-13","2021-12-13","2021-12-13","2021-01-12","2023-07-18","2022-03-16","2022-10-10","2022-11-04","2022-11-04","2022-11-04","2023-07-18","2023-07-18","2023-07-18","2023-07-18","2023-07-18","2022-04-11","2021-05-25","2022-12-09","2021-11-12","2023-04-10","2021-06-08","2022-06-09","2021-10-13","2021-05-19","2021-02-11","2021-02-11","2021-10-13","2023-04-10"],"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":[["","67877026218","RIZATRIPTAN","10 MG","9","Select","Select",""],["","76385011150","CARVEDILOL","6.25 MG","180","Select","Select",""],["","16571068701","HYDROXYCHLOR","TAB 200MG","60","Select","Select",""],["","65162037210","OXYBUTYNIN","TAB 10MG ER","30","Select","Select",""],["","68180086111","AZITHROMYCIN","250 MG","6","Select","Select",""],["","00093100301","BUSPIRONE","TAB 15MG","90","Select","Select",""],["","43547028950","BUPROPION","TAB 150MG SR","180","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","63","Select","Select",""],["","65862078430","ESOMEPRA MAG","CAP 40MG DR","30","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","120","Select","Select",""],["","65162027250","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","55111064530","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","68645059459","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","68382004101","PROMETHAZINE","TAB 25MG","60","Select","Select",""],["","00469260290","MYRBETRIQ","TAB 50MG","30","Select","Select",""],["","45802005935","NYSTATIN","100000\/G","15","Select","Select",""],["","67877052830","SOLIFENACIN","TAB 10MG","30","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","30","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","68462038730","SOLIFENACIN SUCCINATE","10 MG","90","Select","Select",""],["","43598086360","BUPROPION HCL SR","150 MG","180","Select","Select",""],["","43598072101","HYDROXYCHLOROQUINE SULFATE","200 MG","60","Select","Select",""],["","69584009350","BUSPIRONE HCL","15 MG","90","Select","Select",""],["","53746052101","PROMETHAZINE HCL","25 MG","60","Select","Select",""],["","50111056001","TRAZODONE HCL","50 MG","30","Select","Select",""],["","63304069205","CLINDAMYCIN HCL","150 MG","63","Select","Select",""],["","00116200116","CHLORHEXIDINE GLUCONATE","0.12 %","473","Select","Select",""],["","68180065208","DOXYCYCLINE MONOHYDRATE","100 MG","14","Select","Select",""],["","00093100301","BUSPIRONE TAB","15MG","270","Select","Select",""],["","16571068701","HYDROXYCHLOR TAB","200MG","60","Select","Select",""],["","33342008841","RIZATRIPTAN TAB","10MG","9","Select","Select",""],["","43547028950","BUPROPION TAB","150MG SR","180","Select","Select",""],["","68382009305","CARVEDILOL TAB","6.25MG","180","Select","Select",""],["","65162037210","OXYBUTYNIN TAB","10MG ER","30","Select","Select",""],["","65862078430","ESOMEPRA MAG CAP","40MG DR","30","Select","Select",""],["","00143122701","DICYCLOMINE TAB","20MG","120","Select","Select",""],["","65162027250","SMZ\/TMP DS TAB","800-160","20","Select","Select",""],["","55111064530","OMEPRAZOLE CAP","40MG","30","Select","Select",""],["","63304069205","CLINDAMYCIN CAP","150MG","63","Select","Select",""],["","68645059459","FAMOTIDINE TAB","20MG","60","Select","Select",""],["","68382004101","PROMETHAZINE TAB","25MG","60","Select","Select",""],["","00469260290","MYRBETRIQ TAB","50MG","30","Select","Select",""],["","67877052830","SOLIFENACIN TAB","10MG","30","Select","Select",""],["","45802005935","NYSTATIN CRE","100000","15","Select","Select",""],["","55111018015","TIZANIDINE TAB","4MG","30","Select","Select",""],["","50111056001","TRAZODONE TAB","50MG","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":""}]}]}