{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KAREN  M COLE","gend":1,"add":"1590 TODDSBURY RD APT 86","city":"ALTAVISTA","state":"VA","zip":"24517-9998","dob":"1983-02-02","age":"","mstatus":"","insh":"2032101*01","cliId":"","pno":5408759060,"cno":5408759060,"email":"","ename":"","eno":"","pphy":"PAWLAK, RONALD MD","ppno":4343762325,"pcpadd":"104 CAROLINA AVE","pcpcity":"BROOKNEAL","pcpstate":"VA","pcpzip":"24528-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4343762081,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F40.01","F43.12","F33.9","F41.0","N92.5","Z20.828","F41.9","T43.225A","F32.9","I10.","E78.5","F17.210","Z88.8","Z79.899","M54.2","M62.81","R26.2","R20.0","S31.135A","F60.0","G47.33","F33.1","E11.9","Z00.00","Z72.0","Z86.59","F60.9","N93.9","Z88.6","Z32.02","J02.9","G47.19","R07.89","R51.9","H53.8","R42.","F43.10","N93.8","R30.0","B35.1","R73.03","D72.829","R31.29","R10.2","R94.31","M54.6","R11.0","R35.0","E78.00","Z65.8","E11.59","D50.9","E11.69","M62.838","R00.0","G47.30","L60.0","F60.3","R07.9","R26.89","F41.1","F33.0","E86.0","I49.9","M25.531","F51.5","N64.4","N39.46","R53.1","R73.9","R10.31","R19.7","R00.2","Z20.822","R52.","M54.5","N39.0","K21.9","R10.13","M79.662","R60.0"],"date":["2023-03-13","2023-01-31","2022-05-26","2022-03-14","2022-03-01","2021-08-31","2023-04-18","2021-09-07","2021-09-25","2023-04-24","2023-04-18","2023-04-24","2021-09-25","2021-09-29","2022-07-08","2022-01-12","2022-01-12","2022-01-21","2022-01-28","2022-07-27","2022-10-25","2023-03-13","2022-11-21","2022-11-21","2023-01-24","2023-03-13","2023-01-31","2021-12-09","2021-09-25","2021-10-11","2022-01-14","2022-01-14","2022-02-09","2022-07-08","2022-07-08","2022-07-08","2023-04-25","2021-06-27","2021-03-10","2021-12-27","2021-01-12","2021-01-12","2021-01-12","2021-02-07","2021-11-04","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2023-04-18","2021-10-27","2021-12-27","2021-10-27","2023-04-18","2021-12-27","2021-12-27","2023-03-13","2022-02-09","2022-04-19","2022-11-07","2022-11-07","2021-04-12","2021-09-29","2021-11-16","2021-11-16","2021-11-16","2022-06-10","2021-10-19","2021-11-04","2021-12-16","2021-12-16","2021-10-18","2021-12-01","2021-02-07","2021-02-07","2021-10-03","2021-10-03","2021-10-03","2023-04-18","2023-04-18"],"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":[["","00093342501","LORAZEPAM","TAB 0.5MG","2","Select","Select",""],["","68462030450","NORETHIN ACE","TAB 5MG","60","Select","Select",""],["","69097083305","SERTRALINE","TAB 25MG","30","Select","Select",""],["","45802014167","CICLOPIROX","SOL 0.08","7","Select","Select",""],["","68462030529","NORETHINDRON","TAB 0.35MG","28","Select","Select",""],["","68645055354","LISINOPRIL","20 MG","180","Select","Select",""],["","16729020001","BUSPIRONE","TAB 5MG","90","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","50","Select","Select",""],["","08290320109","BD PEN NEEDL","MIS 31GX8MM","100","Select","Select",""],["","75826011510","PHENAZOPYRID","TAB 200MG","6","Select","Select",""],["","74312001200","IRON","TAB 28MG","15","Select","Select",""],["","11845013751","FERROUS GLUC","TAB 240MG","100","Select","Select",""],["","68382003416","VENLAFAXINE","CAP 37.5 ER","30","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","21","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","50428029828","CVS IRON","TAB 27MG","100","Select","Select",""],["","50228014605","HYDROCHLOROT","CAP 12.5MG","30","Select","Select",""],["","00093081001","NORTRIPTYLIN","CAP 10MG","60","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","28","Select","Select",""],["","68462018117","CLOTRIMAZOLE","CRE 0.01","45","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","28","Select","Select",""],["","80681002000","MULTIVITAMIN","TAB ","30","Select","Select",""],["","08626412301","BLOOD GLUCOS","KIT SYSTEM","1","Select","Select",""],["","70377002811","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","67877041301","METFORMIN","TAB 500MG ER","90","Select","Select",""],["","08271036100","LANCETS ULTR","MIS THIN","100","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","14","Select","Select",""],["","65862086001","FAMOTIDINE","TAB 40MG","14","Select","Select",""],["","45802026337","CLINDAMYCIN","MIS 0.01","60","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","10","Select","Select",""],["","69367021001","IRON COMPLEX","CAP 150MG","30","Select","Select",""],["","70954001910","PRAZOSIN HCL","CAP 1MG","30","Select","Select",""],["","16571066001","MECLIZINE","TAB 12.5MG","30","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","12","Select","Select",""],["","00093005805","TRAMADOL HCL","TAB 50MG","12","Select","Select",""],["","65162068090","PROMETHAZINE","SOL DM","120","Select","Select",""],["","08080575000","CURITY PREP","PAD ALCOHOL","100","Select","Select",""],["","59779046768","ASPIRIN LOW","CHW 81MG","36","Select","Select",""],["","59762121003","DESVENLAFAX","TAB 25MG ER","30","Select","Select",""],["","73089008112","VAZALORE","CAP 81MG","30","Select","Select",""],["","00172392760","DIAZEPAM","10 MG","30","Select","Select",""],["","80681012800","VITAMIN B-12","TAB 500MCG","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","100","Select","Select",""],["","16500050379","ONE-A-DAY","TAB WOMENS","30","Select","Select",""],["","51991020311","FERREX 150","CAP 150MG","30","Select","Select",""],["","11877001140","BINAXNOW COV","KIT HOME TES","8","Select","Select",""],["","81131077943","EQ ONE DAILY","TAB WOMENS","30","Select","Select",""],["","43547028010","ESCITALOPRAM","TAB 5MG","30","Select","Select",""],["","16729013616","CLONAZEPAM","0.5 MG","60","Select","Select",""],["","68645052154","SERTRALINE HCL","25 MG","30","Select","Select",""],["","13668021630","ARIPIPRAZOLE","2 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":""}]}]}