{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROLLINS RUSS PITTMAN","gend":0,"add":"1201 LONG MEADOWS DR APT H11","city":"LYNCHBURG","state":"VA","zip":"24502-9998","dob":"1961-04-29","age":"","mstatus":"","insh":"20077362*01","cliId":"","pno":4342296199,"cno":4342296199,"email":"","ename":"","eno":"","pphy":"UPSHAW, SELESTE 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":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C15.4","I63.9","F10.20","F41.9","I10.","Z72.0","C15.9","E44.0","R41.82","G45.9","Z51.12","Z23.","Z45.2","E86.0","I65.22","F33.2","G93.89","R90.82","R13.10","K22.8","Z51.0","C15.5","C77.1","Z92.21","E78.5","Z86.73","Z79.82","Z79.899","F17.200","R13.12","D61.818","Z85.01","F17.210","I25.10","F34.1","R93.89","T82.898A","R12.","C77.9","E87.2","R26.89","E87.6","R40.4","R41.0","I65.29","R19.7","E78.2","NO DATA","R68.89","T85.898A","R51.9"],"date":["2023-09-08","2022-08-23","2023-09-19","2021-10-24","2023-07-17","2022-04-29","2023-03-27","2021-10-24","2021-10-25","2021-10-25","2022-07-07","2022-12-02","2021-09-07","2021-10-22","2022-03-09","2021-10-01","2022-08-23","2022-08-23","2023-07-11","2021-08-31","2021-10-01","2022-03-21","2021-10-01","2021-10-01","2021-10-01","2022-03-21","2021-10-24","2021-10-01","2021-10-01","2022-12-27","2021-10-24","2021-10-24","2021-10-24","2022-03-21","2022-01-20","2023-01-12","2023-01-12","2023-02-24","2021-10-24","2021-10-24","2021-10-24","2021-10-24","2021-10-24","2021-10-24","2021-10-25","2022-09-26","2022-09-26","2023-03-27","2023-03-27","2023-02-24","2023-02-24"],"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":[["","57664037708","TRAMADOL HCL","TAB 50MG","60","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","66689002316","HYDROCO\/APAP","SOL 7.5-325","473","Select","Select",""],["","65862035705","CLOPIDOGREL","75 MG","90","Select","Select",""],["","57237001030","MIRTAZAPINE","45 MG","90","Select","Select",""],["","68462039610","OMEPRAZOLE","20 MG","90","Select","Select",""],["","65862018830","ONDANSETRON","TAB 8MG","30","Select","Select",""],["","57664047758","METOPROL TAR","TAB 50MG","180","Select","Select",""],["","50228014610","HYDROCHLOROT","CAP 12.5MG","30","Select","Select",""],["","00172572960","FAMOTIDINE","40 MG","30","Select","Select",""],["","69097012815","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","00536110888","NICOTINE TD","DIS 21MG\/24H","28","Select","Select",""],["","43598016430","OLANZAPINE","TAB 5MG","30","Select","Select",""],["","00832532511","POT CL MICRO","TAB 20MEQ ER","14","Select","Select",""],["","16714033002","GABAPENTIN","600 MG","60","Select","Select",""],["","68382080505","TRAZODONE","TAB 50MG","30","Select","Select",""],["","72205002599","ATORVASTATIN","TAB 80MG","90","Select","Select",""],["","59746032530","VALACYCLOVIR","TAB 1GM","20","Select","Select",""],["","16714008111","HYDROXYZ HCL","TAB 10MG","30","Select","Select",""],["","00781261301","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","16729016917","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","00054472831","PREDNISONE","TAB 5MG","84","Select","Select",""],["","69238106901","POT CHLORIDE","TAB 20MEQ ER","10","Select","Select",""],["","16729016917","ESCITALOPRAM OXALATE","10 MG","30","Select","Select",""],["","68180096903","LEVOTHYROXINE SODIUM","100 MCG","30","Select","Select",""],["","66689002316","HYDROCODONE-ACETAMINOPHEN","7.5-325\/15","946","Select","Select",""],["","00406055201","OXYCODONE HCL","5 MG","180","Select","Select",""],["","50228014610","HYDROCHLOROTHIAZIDE","12.5 MG","30","Select","Select",""],["","52817036100","METOPROLOL TARTRATE","50 MG","60","Select","Select",""],["","72205002599","ATORVASTATIN CALCIUM","80 MG","90","Select","Select",""],["","66689002316","HYDROCO\/APAP SOL","7.5-325","946","Select","Select",""],["","65862035790","CLOPIDOGREL TAB","75MG","90","Select","Select",""],["","67877022301","GABAPENTIN CAP","300MG","90","Select","Select",""],["","00832532511","POT CL MICRO TAB","20MEQ ER","14","Select","Select",""],["","59746032530","VALACYCLOVIR TAB","1GM","20","Select","Select",""],["","52817036100","METOPROL TAR TAB","50MG","180","Select","Select",""],["","67877051490","ATORVASTATIN TAB","80MG","90","Select","Select",""],["","50228017705","GABAPENTIN TAB","600MG","60","Select","Select",""],["","69097012805","AMLODIPINE TAB","10MG","30","Select","Select",""],["","16729018217","HYDROCHLOROT TAB","12.5MG","30","Select","Select",""],["","57237001030","MIRTAZAPINE TAB","45MG","90","Select","Select",""],["","68382080505","TRAZODONE TAB","50MG","30","Select","Select",""],["","00536110888","NICOTINE TD DIS","21MG\/24H","28","Select","Select",""],["","68462039610","OMEPRAZOLE CAP","20MG","90","Select","Select",""],["","16714008111","HYDROXYZ HCL TAB","10MG","30","Select","Select",""],["","00781261301","AMOXICILLIN CAP","500MG","21","Select","Select",""],["","50228014610","HYDROCHLOROT CAP","12.5MG","30","Select","Select",""],["","69238106901","POT CHLORIDE TAB","20MEQ ER","10","Select","Select",""],["","16729016917","ESCITALOPRAM TAB","10MG","30","Select","Select",""],["","00054472831","PREDNISONE TAB","5MG","84","Select","Select",""],["","68382056510","METOPROLOL SUCCINATE","50 MG","90","Select","Select",""],["","00536110888","NICOTINE PATCH","21 MG\/24HR","14","Select","Select",""],["","31722071310","PANTOPRAZOLE SODIUM","40 MG","180","Select","Select",""],["","69452027120","LOPERAMIDE","2 MG","60","Select","Select",""],["","00904772524","ANTI-DIARRHEAL","2 MG","48","Select","Select",""],["","00245010811","FERROUS SULFATE","325(65) 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":""}]}]}