{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARGIE MINNIS","gend":1,"add":"5187 FALKLAND ROAD","city":"SCOTTSBURG","state":"VA","zip":"24589-9998","dob":"1963-03-07","age":"","mstatus":"","insh":"20068178*01","cliId":"","pno":4344700052,"cno":4344700052,"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":"","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":["F25.9","K04.01","K08.89","K02.9","J06.9","NO DATA","M25.561","M79.604","M19.90","R68.84","M19.011","K04.7","B37.0","G60.3","K59.00","E78.5","E03.9","G25.81","S63.693A","M19.041","M19.042","R10.31","R68.89","R10.9","R13.19","K21.9","R11.0","K59.01","G89.4","F41.9","Z68.33","Z12.31","R10.32","R94.8","F17.200","Z79.899","Z88.5","M25.511","R93.5","E66.9","Z68.32","G47.00"],"date":["2023-03-16","2022-08-12","2022-08-12","2022-08-12","2022-12-28","2023-03-01","2022-05-02","2022-07-11","2022-06-30","2022-07-19","2022-02-01","2022-08-13","2022-08-13","2023-04-04","2022-09-26","2022-10-24","2022-10-24","2022-10-24","2021-05-05","2021-05-05","2021-05-05","2021-03-09","2021-03-09","2021-03-31","2021-03-31","2021-03-31","2021-03-31","2021-03-31","2021-03-31","2021-03-31","2022-02-14","2022-02-14","2022-06-30","2022-06-30","2022-08-12","2022-06-30","2022-08-12","2021-11-11","2022-06-30","2022-08-12","2022-08-12","2023-04-04"],"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":[["","67877024601","QUETIAPINE","TAB 200MG","30","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","00456120130","LINZESS","CAP 145MCG","30","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","00115180401","HYDROXYZ PAM","CAP 50MG","90","Select","Select",""],["","13107015490","PAROXETINE","TAB 10MG","30","Select","Select",""],["","69238183301","LEVOTHYROXIN","TAB 88MCG","90","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","4","Select","Select",""],["","00093005805","TRAMADOL HCL","TAB 50MG","18","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","30","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","59779045888","ALLERGY RLF","TAB 10MG","90","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","00781185220","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","64380071307","BENZONATATE","CAP 200MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","69842031278","8HR PAIN ER","TAB 650MG","30","Select","Select",""],["","68382005105","MELOXICAM","15 MG","30","Select","Select",""],["","53489047901","SULINDAC","TAB 200MG","30","Select","Select",""],["","63402030430","LATUDA","TAB 40MG","30","Select","Select",""],["","51991029301","OXCARBAZEPIN","TAB 300MG","60","Select","Select",""],["","61874011530","VRAYLAR","CAP 1.5MG","30","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","240","Select","Select",""],["","27241009903","DULOXETINE","CAP 60MG","30","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","42571012290","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","59779054462","ARTHRTS PAIN","TAB 650MG","30","Select","Select",""],["","00121087316","LACTULOSE","SOL 10GM\/15","450","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","68180046503","SIMVASTATIN","80 MG","90","Select","Select",""],["","51267089099","CONTRAVE","TAB 8-90MG","120","Select","Select",""],["","68462011060","TOPIRAMATE","200 MG","30","Select","Select",""],["","16729023401","ROPINIROLE","TAB 1MG","30","Select","Select",""],["","59779030602","CVS PURELAX","POW ","238","Select","Select",""],["","45802048678","DOCUSATE SOD","CAP 100MG","30","Select","Select",""],["","60432046400","LIDOCAINE","SOL 2% VISC","300","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","41100080676","MIRALAX","POW 3350 NF","10","Select","Select",""],["","00121086802","NYSTATIN","SUS 100000","200","Select","Select",""],["","65162010350","GABAPENTIN","CAP 400MG","30","Select","Select",""],["","75834002012","VITAMIN D3","CAP 50000UNT","4","Select","Select",""],["","00093226301","AMOXICILLIN","TAB 500MG","20","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","63","Select","Select",""],["","45802086802","POLYETH GLYC","POW 3350 NF","238","Select","Select",""],["","52817033200","CYCLOBENZAPRINE HCL","10 MG","30","Select","Select",""],["","69238116609","DOXEPIN HCL","10 MG","30","Select","Select",""],["","69097068105","PREGABALIN","100 MG","60","Select","Select",""],["","27241009903","DULOXETINE HCL","60 MG","30","Select","Select",""],["","67877024601","QUETIAPINE FUMARATE","200 MG","30","Select","Select",""],["","45802086802","POLYETHYLENE GLYCOL","3350 17 G\/DOSE","238","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":""}]}]}