{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARTY  D GOODMAN","gend":0,"add":"5849 MT CROSS ROAD","city":"DANVILLE","state":"VA","zip":"24540-9998","dob":"1978-06-07","age":"","mstatus":"","insh":"2380818*01","cliId":"","pno":4347130852,"cno":4347130852,"email":"","ename":"","eno":"","pphy":"GRABOWSKI, KRISTEN NP","ppno":4348350105,"pcpadd":"2767 FRANKLIN TURNPIKE","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24540-9998","pcpcounty":"","pcpid":"","pcpname":"Sovah Family Medicine - Mt Hermon","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4348350295,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.0","F41.1","F60.0","F60.2","F44.81","M47.22","M47.26","G89.4","S05.01XA","R11.2","R19.7","Z20.822","I10.","T16.1XXA","E78.00","M54.17","M54.6","F20.0","Z88.5","Z91.030","R51.9","Z79.899","S80.11XA","M79.89","G89.29","W22.8XXA","F33.9","M54.2","M54.5","M25.461","F31.9","K21.9","F20.9","W01.0XXA","M79.604","Y93.K1","Y92.009","F11.20","NO DATA","Z79.891","S89.91XA","R60.0","S30.861A","L30.9","B35.6","E78.1","F34.1","F41.9","R73.03","E66.01","Z68.41","F43.12","R42.","J98.4","M54.15","Z11.59","Z23.","Z51.81"],"date":["2023-03-16","2023-03-16","2023-03-16","2021-07-19","2021-07-19","2023-04-20","2022-08-01","2023-04-20","2021-09-15","2021-11-01","2021-11-01","2021-11-01","2023-01-16","2022-09-17","2022-09-17","2023-03-16","2023-02-21","2021-05-21","2021-11-01","2021-11-01","2021-11-01","2023-04-20","2023-01-16","2023-01-16","2023-01-16","2023-01-16","2023-03-16","2021-09-14","2021-09-14","2023-01-11","2023-01-16","2023-01-16","2023-01-16","2023-01-11","2023-01-16","2023-01-10","2023-01-10","2022-09-01","2021-12-02","2023-02-21","2023-01-16","2023-01-16","2021-05-19","2022-04-08","2021-07-07","2022-10-13","2022-10-13","2022-10-13","2022-10-13","2021-09-21","2022-10-13","2022-10-13","2022-08-29","2022-08-29","2022-09-29","2022-04-08","2022-10-13","2023-02-21"],"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":[["","00406852001","OXYCODONE","TAB 20MG","120","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","50383082416","SMZ-TMP","SUS 200-40\/5","35","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","67877025001","QUETIAPINE","TAB 100MG","30","Select","Select",""],["","00527512162","NYSTATIN","SUS 100000","60","Select","Select",""],["","51991075033","DULOXETINE","CAP 40MG","30","Select","Select",""],["","70700015010","OMEPRAZOLE","20 MG","90","Select","Select",""],["","00603506221","PERPHENAZINE","TAB 8MG","30","Select","Select",""],["","68462013701","OXCARBAZEPIN","TAB 150MG","60","Select","Select",""],["","00832712315","DIVALPROEX","TAB 250MG DR","60","Select","Select",""],["","51672412301","CARBAMAZEPIN","TAB 100MGER","30","Select","Select",""],["","67877022301","GABAPENTIN","CAP 300MG","120","Select","Select",""],["","64980051501","OFLOXACIN","DRO 0.3% OP","10","Select","Select",""],["","49502010202","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","00574200830","NYSTOP","POW 100000","90","Select","Select",""],["","31722015130","VALSARTAN","40 MG","135","Select","Select",""],["","51672128202","TRIAMCINOLON","CRE 0.001","60","Select","Select",""],["","42858035340","BUPRENORPHIN","DIS 7.5\/HR","4","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","30","Select","Select",""],["","59011075704","BUTRANS","DIS 7.5\/HR","4","Select","Select",""],["","69547035302","NARCAN","SPR ","4","Select","Select",""],["","00093216568","NALOXONE HCL","SPR 4MG","2","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","51991075033","DULOXETINE HCL","40 MG","30","Select","Select",""],["","68462013701","OXCARBAZEPINE","150 MG","60","Select","Select",""],["","00713022580","TRIAMCINOLONE ACETONIDE","0.1 %","80","Select","Select",""],["","57237007710","ONDANSETRON ODT","4 MG","30","Select","Select",""],["","67877024901","QUETIAPINE FUMARATE","50 MG","30","Select","Select",""],["","00406852001","OXYCODONE HCL","20 MG","120","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":""}]}]}