{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DANIELLE LAMBERT","gend":1,"add":"35 MILKWEED LN","city":"LYNCHBURG","state":"VA","zip":"24501-9998","dob":"2000-11-16","age":"","mstatus":"","insh":"2425499*01","cliId":"","pno":4342327943,"cno":4342327943,"email":"","ename":"","eno":"","pphy":"JUN, JEAN NP","ppno":4349294357,"pcpadd":"200 Amelon Square,","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":4349291093,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R89.2","NO DATA","F12.929","F60.3","Z20.822","G89.29","R15.9","R20.8","R32.","K62.89","F31.62","R07.89","R77.8","R51.9","R55.","L91.8","L98.9","G47.33","G47.10","R20.0","R20.9","F41.9","R45.4","F33.9","F31.9","Z39.1","Z34.82","Z34.83","K08.89","H60.501","H92.01","O90.0","R11.0","Z13.228","Z13.0","F32.9","R42.","S13.4XXA","S20.229A","S00.03XA","R03.0","R07.9","Z09.","E66.9","Z72.0","M25.511","J02.9","J20.9","R22.1"],"date":["2021-11-02","2022-03-17","2021-11-02","2023-06-21","2022-04-19","2022-03-17","2022-03-17","2022-03-17","2022-03-17","2022-03-17","2022-12-02","2022-03-23","2022-04-25","2022-03-23","2022-09-16","2022-04-12","2022-04-12","2022-07-15","2022-07-15","2022-08-25","2022-08-25","2023-03-14","2022-10-20","2022-10-20","2023-06-21","2021-11-04","2021-11-04","2021-11-04","2023-01-03","2023-01-03","2023-01-03","2021-12-22","2022-08-29","2022-08-29","2022-08-29","2023-03-14","2021-11-02","2022-02-08","2022-02-08","2022-02-08","2022-02-08","2022-03-23","2022-04-25","2022-04-25","2022-04-25","2022-08-16","2021-12-27","2022-04-19","2022-12-12"],"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":[["","31722054501","LITHIUM CARB CAP","300MG","60","Select","Select",""],["","69097094312","GABAPENTIN CAP","300MG","90","Select","Select",""],["","69584061150","METHOCARBAM TAB","500MG","15","Select","Select",""],["","66993037083","MEDROXYPR AC INJ","150MG\/ML","1","Select","Select",""],["","59417010110","VYVANSE CAP","10MG","30","Select","Select",""],["","24658031205","DOXYCYCL HYC TAB","100MG","20","Select","Select",""],["","16571020210","DICLOFENAC TAB","50MG DR","21","Select","Select",""],["","69097084507","CYCLOBENZAPR TAB","5MG","20","Select","Select",""],["","68462010530","ONDANSETRON TAB","4MG","30","Select","Select",""],["","00781618667","CIPROFLOXACIN-DEXAMETHASONE","0.3 %-0.1%","7.5","Select","Select",""],["","66993037083","MEDROXYPROGESTERONE ACETATE","150 MG\/ML","1","Select","Select",""],["","50111033401","METRONIDAZOLE","500 MG","14","Select","Select",""],["","69097083412","SERTRALINE HCL","50 MG","30","Select","Select",""],["","42806016005","HYDROXYZINE HCL","25 MG","45","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":""}]}]}