{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TIMOTHY  W ROYAL","gend":0,"add":"126 KIRKLAND DR","city":"MADISON HEIGHTS","state":"VA","zip":"24572-9998","dob":"1981-12-08","age":"","mstatus":"","insh":"20064528*01","cliId":"","pno":2763360392,"cno":2763360392,"email":"","ename":"","eno":"","pphy":"ALEXANDER, YVETTE LANEA NP","ppno":4349475967,"pcpadd":"320 FEDERAL ST,","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":"24504-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4349475971,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","I10.","J45.41","M54.16","J80.","R06.9","R06.02","R09.02","R06.2","R05.","J39.9","Z20.822","J45.901","J45.909","Z88.5","Z88.0","Z88.6","Z91.030","J06.9","R77.8","M62.81","G89.4","M47.26","H35.3131","H40.013","H25.092","H52.13","Z00.01","R45.86","F41.9","F32.9","F25.1","Z71.85","W19.XXXA","M54.9","J45.20","Z23.","M47.899","Z86.79","Z72.0","R13.12","Z13.84","R05.9","M54.5","M25.562","G89.29","R10.84","R52.","R06.89","Z01.818","M54.42","M54.41","R68.89","NO DATA","F33.0"],"date":["2022-06-08","2022-12-20","2021-10-15","2021-11-09","2021-10-15","2023-07-14","2023-07-14","2021-10-15","2023-07-14","2021-08-02","2021-08-02","2023-07-14","2021-10-15","2023-07-14","2021-09-04","2021-09-04","2021-09-04","2021-09-04","2021-10-15","2021-10-15","2022-12-23","2022-12-23","2022-12-23","2021-08-10","2021-08-10","2021-08-10","2021-08-10","2022-12-20","2022-12-20","2022-12-20","2022-12-20","2023-06-13","2022-12-20","2022-12-20","2022-12-20","2022-12-20","2022-12-20","2022-09-20","2022-06-21","2022-06-21","2022-06-21","2022-06-21","2023-07-14","2021-06-22","2021-06-22","2021-08-12","2021-08-22","2021-08-22","2021-10-15","2021-11-05","2021-08-12","2021-08-12","2023-07-14","2023-07-14","2023-07-10"],"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":[["","68180072103","AMLODIPINE TAB","10MG","30","Select","Select",""],["","00186037020","SYMBICORT AER","160-4.5","10","Select","Select",""],["","29300041510","CYCLOBENZAPR TAB","10MG","15","Select","Select",""],["","69097014260","ALBUTEROL AER HFA","","7","Select","Select",""],["","27241009903","DULOXETINE CAP","60MG","30","Select","Select",""],["","65862049101","QUETIAPINE TAB","100MG","30","Select","Select",""],["","13668004701","LAMOTRIGINE TAB","100MG","30","Select","Select",""],["","42806071405","BENZONATATE CAP","100MG","30","Select","Select",""],["","00310737020","BUDES\/FORMOT AER","160-4.5","10","Select","Select",""],["","60505025203","TIZANIDINE TAB","4MG","180","Select","Select",""],["","00527293437","PREDNISONE TAB","20MG","21","Select","Select",""],["","69097015807","MELOXICAM TAB","7.5MG","30","Select","Select",""],["","47335070349","ALBUTEROL NEB","0.083%","75","Select","Select",""],["","43598029290","PREGABALIN CAP","50MG","60","Select","Select",""],["","76385012350","METHOCARBAM TAB","500MG","90","Select","Select",""],["","00186091706","PULMICORT INH","90MCG","1","Select","Select",""],["","68180051303","LISINOPRIL","5 MG","30","Select","Select",""],["","60505025203","TIZANIDINE HCL","4 MG","180","Select","Select",""],["","76385012350","METHOCARBAMOL","500 MG","90","Select","Select",""],["","00186091706","PULMICORT FLEXHALER","90 MCG","1","Select","Select",""],["","47335075649","IPRATROPIUM-ALBUTEROL","0.5-3MG\/3","30","Select","Select",""],["","57237001930","DULOXETINE HCL","60 MG","30","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","69097015807","MELOXICAM","7.5 MG","30","Select","Select",""],["","68180072103","AMLODIPINE BESYLATE","10 MG","30","Select","Select",""],["","00310737020","BUDESONIDE-FORMOTEROL FUMARATE","160-4.5MCG","10.2","Select","Select",""],["","29300014901","QUETIAPINE FUMARATE","100 MG","30","Select","Select",""],["","13668004701","LAMOTRIGINE","100 MG","30","Select","Select",""],["","43598029290","PREGABALIN","50 MG","60","Select","Select",""],["","00186037020","SYMBICORT","160-4.5MCG","10.2","Select","Select",""],["","47335070349","ALBUTEROL SULFATE","2.5 MG\/3ML","75","Select","Select",""],["","23155000810","HYDROCHLOROTHIAZIDE","25 MG","30","Select","Select",""],["","41167005840","ASPERCREME LIDOCAINE","4 %","10","Select","Select",""],["","00093005805","TRAMADOL HCL","50 MG","10","Select","Select",""],["","64380094906","PREDNISONE","50 MG","5","Select","Select",""],["","65862051601","NAPROXEN SODIUM","550 MG","20","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":""}]}]}