{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RICHARD M TUCKER","gend":0,"add":"133 BAUGH ST","city":"DANVILLE","state":"VA","zip":"24540-9998","dob":"1966-12-16","age":"","mstatus":"","insh":"20072435*01","cliId":"","pno":4344293011,"cno":4344293011,"email":"","ename":"","eno":"","pphy":"BEACH, JACOB NP","ppno":4348573600,"pcpadd":"414 PARK AVE","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24541-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4348573601,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R06.00","I24.9","R07.9","I25.10","E11.65","R55.","I10.","E78.5","E09.10","I21.3","Z91.81","R26.89","R53.1","M19.072","I87.2","E10.621","E10.40","L97.509","I25.5","E11.9","E11.3293","H25.13","H33.322","NO DATA","Z79.4","I49.1","R42.","I95.9","R11.0","R33.9","K21.9","Z86.73","E11.00","I24.0","I65.21","T82.855A","I21.4","R57.0","G62.9","M79.89","G45.9","I51.3","I20.0","R74.8","R40.4","R40.20","S91.309A","E11.69","E11.649","R35.0","E08.65","E10.10","E46.","E10.42","E11.42","E83.42","E83.51","E87.6","V58.69","R74.01","R26.2","D69.6","I48.0","F17.200","Z95.5","Z82.49","Z83.3","F32.9","R07.89","F03.90","I25.2","Z91.19","Z79.01","R41.82","Z88.8","R53.81","H10.32","H57.12","H20.042","S05.02XA","L03.213","Y99.9","R73.9","H57.10","R51.9","H53.8"],"date":["2022-03-22","2022-04-14","2022-04-14","2022-04-16","2022-05-27","2022-04-14","2023-05-03","2023-05-03","2022-04-21","2022-05-11","2022-10-25","2022-10-25","2022-10-25","2022-11-14","2022-11-14","2022-11-22","2022-11-22","2022-11-14","2022-05-11","2023-05-03","2021-11-15","2021-11-15","2021-11-15","2022-05-27","2023-05-03","2022-04-14","2022-05-11","2022-04-16","2021-11-05","2022-04-19","2022-05-02","2022-04-14","2022-04-16","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-05-11","2022-05-12","2022-05-11","2022-05-11","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-10-28","2021-01-05","2021-07-21","2021-07-21","2021-11-05","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-05-02","2021-09-18","2023-04-29","2023-05-03","2021-09-18","2021-09-18","2021-11-05","2021-11-05","2021-11-05","2023-04-29","2023-04-29","2023-05-24","2023-05-04","2023-05-03","2023-05-03","2023-04-29","2023-04-29","2023-05-03","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":[["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA","200","Select","Select",""],["","64764017590","DEXILANT","CAP 60MG DR","30","Select","Select",""],["","20555003900","MELATONIN","TAB 5MG","60","Select","Select",""],["","00024586903","TOUJEO SOLO","INJ 300IU\/ML","4","Select","Select",""],["","16729021816","CLOPIDOGREL","TAB 75MG","30","Select","Select",""],["","23155050110","HYDROXYZ HCL","TAB 25MG","30","Select","Select",""],["","00002143401","TRULICITY","INJ 1.5\/0.5","2","Select","Select",""],["","00378001801","METOPROL TAR","TAB 25MG","60","Select","Select",""],["","65862020199","LOSARTAN POT","TAB 25MG","30","Select","Select",""],["","43547028211","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","68462026430","ROSUVASTATIN","TAB 40MG","30","Select","Select",""],["","70010006505","METFORMIN","TAB 1000MG","60","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","15","Select","Select",""],["","73070010315","INSULIN ASPA","INJ FLEXPEN","15","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","80777027398","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","69238131209","PREGABALIN","CAP 75MG","60","Select","Select",""],["","00002771559","BASAGLAR","INJ 100UNIT","15","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00310621030","FARXIGA","TAB 10MG","30","Select","Select",""],["","24979070406","DEXLANSOPRAZ","CAP 60MG DR","30","Select","Select",""],["","00186077760","BRILINTA","TAB 90MG","60","Select","Select",""],["","08627005303","DEXCOM G6","MIS SENSOR","9","Select","Select",""],["","65862059805","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","00904675180","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","59762330403","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","60505258009","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","21922000909","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00143314205","DOXYCYCL HYC","CAP 100MG","28","Select","Select",""],["","00406012301","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","20","Select","Select",""],["","31722071310","PANTOPRAZOLE SODIUM","40 MG","60","Select","Select",""],["","00116200116","CHLORHEXIDINE GLUCONATE","0.12 %","473","Select","Select",""],["","00574402435","ERYTHROMYCIN","5 MG\/GRAM","3.5","Select","Select",""],["","60505058204","MOXIFLOXACIN","0.5 %","3","Select","Select",""],["","00078084101","CILOXAN","0.3 %","3.5","Select","Select",""],["","42571016242","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","20","Select","Select",""],["","67877032105","IBUPROFEN","800 MG","21","Select","Select",""],["","70069013101","TOBRAMYCIN","0.3 %","5","Select","Select",""],["","60219174802","ATROPINE SULFATE","1 %","2","Select","Select",""],["","03504600323",""," ","60","Select","Select",""],["","60758011905","PREDNISOLONE ACETATE","1 %","10","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":""}]}]}