{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JULIA  A BARBOUR","gend":1,"add":"2345 BURKE ROAD","city":"GRETNA","state":"VA","zip":"24557-9998","dob":"1977-06-17","age":"","mstatus":"","insh":"2395224*01","cliId":"","pno":4342591331,"cno":4342591331,"email":"","ename":"","eno":"","pphy":"TORRES, MICHAEL MD","ppno":4346561274,"pcpadd":"291 MCBRIDE LANE,","pcpcity":"GRETNA","pcpstate":"VA","pcpzip":"24557-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4346563405,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R10.9","Z98.84","M89.8X2","M25.511","R10.13","B34.9","R09.81","R07.0","F41.9","F32.9","J45.909","K21.9","Z20.822","R19.7","S42.254A","L40.0","L40.59","L70.0","L82.1","F17.210","E78.5","E66.3","Z68.27","J45.901","U07.1","R51.9","R53.83","K66.0","K95.89","L40.9","M25.50","G43.819","J45.998","J01.80","M79.672","V54.16","Z72.0","Z68.29","S62.001A","X50.1XXA","E66.01","Z68.28","Z71.3","R59.9","J30.9","G43.909","S92.302A","S60.211A","M25.531","G47.33","E83.19","R07.9","K91.2","R11.2","Z68.25","N39.3","L40.50","V58.89","M54.2","G56.23","Z79.899","G43.001","M25.541","NO DATA","S52.552A","V54.12","M25.532","S52.502A","S52.602A","W01.0XXA","Y99.9"],"date":["2022-09-14","2022-10-26","2022-04-28","2022-04-28","2021-10-27","2021-12-31","2021-12-31","2021-12-31","2023-03-23","2023-03-23","2022-09-14","2022-09-14","2022-05-06","2022-09-14","2022-04-21","2023-02-21","2023-02-21","2022-08-23","2023-02-21","2023-03-23","2023-03-23","2023-03-23","2023-03-23","2021-06-29","2021-09-21","2021-09-21","2021-09-21","2021-11-08","2021-11-08","2022-09-14","2022-08-29","2022-05-06","2022-05-06","2022-05-06","2022-06-30","2022-06-30","2022-10-26","2022-10-26","2021-11-30","2021-11-30","2022-03-03","2022-03-03","2022-03-03","2022-04-28","2022-08-22","2022-09-14","2022-06-16","2021-12-01","2021-12-07","2022-08-23","2022-08-23","2022-08-23","2022-08-23","2022-09-14","2021-07-21","2021-07-21","2021-07-21","2021-12-07","2022-02-11","2022-03-03","2022-02-17","2022-02-17","2021-11-30","2022-09-14","2023-05-31","2023-06-27","2023-06-27","2023-05-29","2023-05-29","2023-05-29","2023-05-29"],"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":[["","42571012290","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","10702000201","PROMETHAZINE","TAB 12.5MG","30","Select","Select",""],["","57894064011","TREMFYA","100 MG\/ML","1","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","60","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","00406012310","HYDROCO\/APAP","TAB 5-325MG","7","Select","Select",""],["","00406117003","NALTREXONE","TAB 50MG","30","Select","Select",""],["","29300011605","TOPIRAMATE","50 MG","180","Select","Select",""],["","43547028211","ESCITALOPRAM","TAB 20MG","90","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","00781716119","CLINDAMY\/BEN","GEL 1.2-5%","45","Select","Select",""],["","72888008000","TRAMADOL HCL","50 MG","20","Select","Select",""],["","59762040101","SUCRALFATE","TAB 1GM","56","Select","Select",""],["","21922000909","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00527128210","DICYCLOMINE","TAB 20MG","20","Select","Select",""],["","16729044316","BUPROPN HCL","TAB 150MG XL","30","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","33342020010","LEVOCETIRIZINE DIHYDROCHLORIDE","5 MG","30","Select","Select",""],["","55111018015","TIZANIDINE HCL","4 MG","60","Select","Select",""],["","64380074207","BUSPIRONE HCL","10 MG","60","Select","Select",""],["","00378668910","PANTOPRAZOLE SODIUM","40 MG","90","Select","Select",""],["","68382004001","PROMETHAZINE HCL","12.5 MG","30","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","27808003501","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","10","Select","Select",""],["","43547028211","ESCITALOPRAM OXALATE","20 MG","90","Select","Select",""],["","57894064011","TREMFYA INJ","100MG\/ML","1","Select","Select",""],["","42571012290","LEVOCETIRIZI TAB","5MG","30","Select","Select",""],["","68382004001","PROMETHAZINE TAB","12.5MG","30","Select","Select",""],["","55111018015","TIZANIDINE TAB","4MG","60","Select","Select",""],["","00406012310","HYDROCO\/APAP TAB","5-325MG","7","Select","Select",""],["","00378668910","PANTOPRAZOLE TAB","40MG","30","Select","Select",""],["","00406117003","NALTREXONE TAB","50MG","30","Select","Select",""],["","47335071013","TOPIRAMATE TAB","50MG","180","Select","Select",""],["","65862001501","AMOXICILLIN TAB","875MG","20","Select","Select",""],["","43547028211","ESCITALOPRAM TAB","20MG","90","Select","Select",""],["","72888008000","TRAMADOL HCL TAB","50MG","20","Select","Select",""],["","59762040101","SUCRALFATE TAB","1GM","56","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","16729044316","BUPROPN HCL TAB","150MG XL","30","Select","Select",""],["","00527128210","DICYCLOMINE TAB","20MG","20","Select","Select",""],["","00781716119","CLINDAMY\/BEN GEL","1.2-5%","45","Select","Select",""],["","21922000909","DICLOFENAC GEL","1%","100","Select","Select",""],["","68180096301","ALBUTEROL AER HFA","","8","Select","Select",""],["","16729044316","BUPROPION XL","150 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":""}]}]}