{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JANICE  M GLASSCOCK","gend":1,"add":"4122 COWFORD ROAD","city":"HALIFAX","state":"VA","zip":"24558-9998","dob":"1968-01-28","age":"","mstatus":"","insh":"20082990*01","cliId":"","pno":4342220530,"cno":4342220530,"email":"","ename":"","eno":"","pphy":"HILL, KAREN P NP","ppno":4347914122,"pcpadd":"705 MAIN STREET","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":4347914126,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C18.7","C78.7","Z12.39","Z92.21","R91.8","Z90.49","Z51.11","Z76.89","R53.83","R11.2","T45.1X5A","K12.39","D50.0","I83.11","Z79.899","Z79.84","Z88.5","I10.","K21.9","E11.51","Z08.","Z85.038","Z85.05","I25.10","NO DATA","K76.0","R93.2","R93.422","R93.421","D17.1","M67.912","M67.911","M89.8X1","M77.11","M77.8","M77.12","D17.5","Z01.810","Z01.812","Z20.822","C18.9","Z12.31","Z95.828","Z01.818","Z45.2"],"date":["2023-02-20","2023-02-20","2023-01-24","2023-01-24","2023-02-20","2023-02-20","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2022-08-05","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2023-01-10","2023-01-10","2023-01-10","2022-11-28","2023-02-20","2023-02-20","2023-02-20","2023-02-20","2023-02-20","2023-02-20","2022-05-02","2022-05-02","2022-05-02","2022-05-02","2022-05-02","2022-05-02","2022-08-04","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-05-03","2022-11-14","2022-11-08","2022-11-14"],"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":[["","29300012501","MELOXICAM","TAB 15MG","30","Select","Select",""],["","00006007861","JANUMET XR","50MG-500MG","30","Select","Select",""],["","33342006410","VALSARTAN","160 MG","30","Select","Select",""],["","45963014230","BUPROPN HCL","TAB 300MG XL","30","Select","Select",""],["","59651039101","BUSPIRONE","TAB 10MG","90","Select","Select",""],["","00006057561","JANUMET","TAB 50-500MG","30","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","00002143380","TRULICITY","0.75MG\/0.5","2","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","24","Select","Select",""],["","59651039101","BUSPIRONE HCL","10 MG","90","Select","Select",""],["","68180032009","BUPROPION XL","300 MG","30","Select","Select",""],["","65862056099","PANTOPRAZOLE SODIUM","40 MG","60","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":""}]}]}