{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"STEVE A HARRIS","gend":0,"add":"111 ROBIN LN","city":"MADISON HEIGHTS","state":"VA","zip":"24572-9998","dob":"1976-02-05","age":"","mstatus":"","insh":"2375094*01","cliId":"","pno":4342219480,"cno":4342219480,"email":"","ename":"","eno":"","pphy":"KOZAK, BRENDA J NP","ppno":4349291400,"pcpadd":"134 ELON ROAD,","pcpcity":"MADISON HEIGHTS","pcpstate":"VA","pcpzip":"24572-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4349290410,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25.551","M62.81","M54.5","E11.00","E11.65","Z79.4","S70.01XA","S80.01XA","M79.661","E11.9","I10.","E78.5","Z87.891","Z88.8","Z79.02","Z79.82","W20.8XXA","Y92.89","L05.91","Z86.73","L98.8","M54.42","F41.9","M51.36","M25.559","M47.816","NO DATA","M47.896","M51.16","M25.552","D66.","M06.9","E11.8","M54.41","G89.29","M54.16","M16.10","R05.9","Z20.822","R53.83","U07.1","R20.2","G25.81","Z00.01","Z71.3","M25.851","Z51.81","J30.2","G43.109","I63.50","F33.2","Z76.89","N30.01","K04.7","K08.89","K05.10","R26.89","R26.81","R51.9","R11.0","E11.3493","H25.13","Z63.8","I63.9","I63.019","M24.811","M25.511","E66.01","I65.23","I65.01","F41.8","Z79.891","R52.","R55.","R61.","W19.XXXA","Z11.59","Z03.89","E11.3393","H40.023","L02.31","E86.0","N17.9","I95.9","R19.7","R10.84","H40.1132","H25.813"],"date":["2022-10-21","2021-08-18","2021-08-17","2021-05-20","2023-05-15","2021-05-20","2021-06-17","2021-06-17","2021-05-26","2023-07-12","2023-07-12","2023-07-12","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-07-21","2023-07-12","2021-08-19","2022-11-30","2022-05-04","2022-11-14","2021-09-30","2022-11-14","2022-11-14","2021-09-30","2021-09-30","2021-09-30","2021-09-30","2021-09-30","2021-09-30","2021-09-30","2022-11-10","2022-03-03","2021-09-30","2022-06-10","2022-06-10","2022-06-10","2022-06-10","2022-11-30","2022-08-31","2021-08-31","2021-08-31","2022-11-30","2022-11-14","2022-11-10","2022-10-11","2022-08-31","2022-08-31","2023-05-25","2023-02-09","2023-03-07","2023-03-07","2023-03-07","2021-08-18","2021-08-18","2022-11-10","2021-05-25","2021-06-15","2021-06-15","2021-06-23","2022-10-11","2022-10-11","2023-03-28","2022-10-21","2022-10-21","2022-11-04","2022-11-04","2022-11-10","2022-11-14","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2022-05-12","2023-03-28","2023-08-31","2023-04-18","2023-05-15","2023-07-12","2023-07-12","2023-07-12","2023-07-12","2023-07-12","2023-08-31","2023-08-31"],"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":[["","00169300725","NOVOLIN","INJ 70\/30 FP","30","Select","Select",""],["","00169183702","NOVOLIN70\/30","INJ RELION","30","Select","Select",""],["","68645055554","LISINOPRIL","TAB 40MG","90","Select","Select",""],["","08317780100","RELION PREMI","TES GLUCOSE","100","Select","Select",""],["","78742026442","RELION ULTRA","MIS THIN 30G","100","Select","Select",""],["","16714079904","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","08317700050","RELION PRIME","TES ","100","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","16714008310","HYDROXYZ HCL","TAB 50MG","90","Select","Select",""],["","81131009885","RELION LANCE","MIS THIN 30G","100","Select","Select",""],["","00093505798","ATORVASTATIN","TAB 80MG","90","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","08290320550","BD PEN NEEDL","MIS 32GX4MM","200","Select","Select",""],["","43547026910","ROPINIROLE","TAB 0.5MG","180","Select","Select",""],["","00169220125","NOVOLOG MIX","70-30 FLEXPEN 70-30\/ML","30","Select","Select",""],["","65862017160","TOPIRAMATE","25 MG","120","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","10","Select","Select",""],["","81131011187","B-12","SUB 500MCG","90","Select","Select",""],["","67877022310","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","30","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","100","Select","Select",""],["","43386035801","HYDROCO\/APAP","TAB 10-325MG","28","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","100","Select","Select",""],["","49035086202","EQ EAR DROPS","SOL 6.5% OT","15","Select","Select",""],["","59746033890","LOSARTAN\/HCT","TAB 100-12.5","90","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","49035045875","ALLERGY REL","TAB 10MG","90","Select","Select",""],["","00093342210","CYCLOBENZAPR","TAB 10MG","90","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","80681012800","VITAMIN B-12","TAB 500MCG","30","Select","Select",""],["","63824000832","MUCINEX","TAB 600MG ER","14","Select","Select",""],["","68180086111","AZITHROMYCIN","250 MG","6","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","42858010301","OXYCOD\/APAP","TAB 7.5-325","90","Select","Select",""],["","64380071207","BENZONATATE","CAP 100MG","15","Select","Select",""],["","62332002431","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","00169430730","RYBELSUS","TAB 7MG","30","Select","Select",""],["","70010000201","COLCHICINE","TAB 0.6MG","3","Select","Select",""],["","98302014807","COMFORT EZ","MIS 33GX4MM","200","Select","Select",""],["","76385012350","METHOCARBAM","TAB 500MG","90","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","40","Select","Select",""],["","08290320550","NANO","2ND GEN PEN NEEDLE 32GX 5\/32\"","200","Select","Select",""],["","00093505798","ATORVASTATIN CALCIUM","80 MG","90","Select","Select",""],["","00172409680","BACLOFEN","10 MG","90","Select","Select",""],["","65862019401","FLUOXETINE HCL","40 MG","30","Select","Select",""],["","16714008310","HYDROXYZINE HCL","50 MG","90","Select","Select",""],["","00193731221","CONTOUR NEXT TEST STRIP","","100","Select","Select",""],["","76385012350","METHOCARBAMOL","500 MG","90","Select","Select",""],["","59746033790","LOSARTAN-HYDROCHLOROTHIAZIDE","50-12.5 MG","30","Select","Select",""],["","80681012800","VITAMIN B-","12 500 MCG","90","Select","Select",""],["","00116200116","CHLORHEXIDINE GLUCONATE","0.12 %","473","Select","Select",""],["","00143924920","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","14","Select","Select",""],["","16571041250","CIPROFLOXACIN HCL","500 MG","20","Select","Select",""],["","13107004601","OXYCODONE-ACETAMINOPHEN","10MG-325MG","90","Select","Select",""],["","63304069205","CLINDAMYCIN HCL","150 MG","28","Select","Select",""],["","70010016305","CETIRIZINE HCL","10 MG","90","Select","Select",""],["","69452035720","ROPINIROLE HCL","0.5 MG","180","Select","Select",""],["","53489011905","DOXYCYCLINE HYCLATE","100 MG","20","Select","Select",""],["","00093101042","MUPIROCIN","2 %","22","Select","Select",""],["","00093342210","CYCLOBENZAPR TAB","10MG","90","Select","Select",""],["","53885000810","ONETOUCH DEL MIS PLUS","33G","100","Select","Select",""],["","70010016305","CETIRIZINE TAB","10MG","30","Select","Select",""],["","53885027210","ONETOUCH TES VERIO","","100","Select","Select",""],["","59746033890","LOSARTAN\/HCT TAB","100-12.5","90","Select","Select",""],["","43547026910","ROPINIROLE TAB","0.5MG","180","Select","Select",""],["","00093505798","ATORVASTATIN TAB","80MG","90","Select","Select",""],["","53746011001","HYDROCO\/APAP TAB","10-325MG","120","Select","Select",""],["","65862017160","TOPIRAMATE TAB","25MG","120","Select","Select",""],["","00169220125","NOVOLOG MIX INJ FLEX REL","","30","Select","Select",""],["","08290320550","BD PEN NEEDL MIS","32GX4MM","200","Select","Select",""],["","40093010225","B-","12 1000 MCG","30","Select","Select",""],["","00088221905","LANTUS SOLOS INJ","100\/ML","15","Select","Select",""],["","16714008310","HYDROXYZ HCL TAB","50MG","90","Select","Select",""],["","63824000832","MUCINEX TAB","600MG ER","14","Select","Select",""],["","60432060416","PROMETHAZINE SYP DM","","100","Select","Select",""],["","50111078751","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","49035045875","ALLERGY REL TAB","10MG","90","Select","Select",""],["","62332002431","FLUOXETINE CAP","40MG","30","Select","Select",""],["","64380071207","BENZONATATE CAP","100MG","15","Select","Select",""],["","00378064205","PREDNISONE TAB","20MG","10","Select","Select",""],["","42858010301","OXYCOD\/APAP TAB","7.5-325","90","Select","Select",""],["","76385012350","METHOCARBAM TAB","500MG","90","Select","Select",""],["","70010000201","COLCHICINE TAB","0.6MG","3","Select","Select",""],["","00169430730","RYBELSUS TAB","7MG","30","Select","Select",""],["","98302014807","COMFORT EZ MIS","33GX4MM","200","Select","Select",""],["","63304069205","CLINDAMYCIN CAP","150MG","40","Select","Select",""],["","00116200116","CHLORHEX GLU SOL","0.12%","473","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","20","Select","Select",""],["","00093031101","LOPERAMIDE","2 MG","24","Select","Select",""],["","00093310905","AMOXICILLIN","500 MG","30","Select","Select",""],["","24208046325","LATANOPROST","0.005 %","2.5","Select","Select",""],["","49035045875","ALLERGY RELIEF","10 MG","90","Select","Select",""],["","49502039475","INSULIN GLARGINE-YFGN","100\/ML (3)","3","Select","Select",""],["","08290320122","ULTRA-FINE NANO PEN NEEDLE","32GX 5\/32\"","100","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":""}]}]}