{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MELISSA  L CREWS","gend":1,"add":"12448 OLD STILLHOUSE ROAD","city":"BOSTON","state":"VA","zip":"22713-9998","dob":"1970-10-28","age":"","mstatus":"","insh":"2451399*01","cliId":"","pno":5405472617,"cno":5405472617,"email":"","ename":"","eno":"","pphy":"PROFFITT, MICHELLE COLLINS NP","ppno":5408256263,"pcpadd":"16268 BENNETT RD","pcpcity":"CULPEPER","pcpstate":"VA","pcpzip":"22701-9998","pcpcounty":"","pcpid":"","pcpname":"Compassion Health Care Inc, dba James Austin Health Center","plan":"OHP","program":"MEDICAID","lob":"M4","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5408254911,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K52.9","R11.2","E11.9","I10.","NO DATA","R10.84","F41.9","E11.65","F32.89","G25.81","E78.2","K59.09","F17.200","A41.9","J18.9","R65.20","J69.0","K59.00","R10.13","E83.39","E87.6","Z79.84","B99.8","E78.5","F31.9","V58.69","Z20.822","R10.9","M25.512","E86.0","E83.89","Z79.4","Z79.899","R19.7","Z82.0","E61.1","E53.8","E55.9","E83.42","K21.9","E11.40","Z82.49","K29.70","K44.9","K29.80","B37.81","F41.8","K29.90","R93.3","K29.50","R06.2","R07.89","R06.02","F32.9","R00.2","N17.9","K31.84","R11.15","R61.","Z87.19","R11.10"],"date":["2022-12-31","2023-04-02","2023-01-15","2023-04-05","2023-04-01","2022-12-28","2023-04-01","2023-01-26","2022-03-02","2023-01-26","2022-03-02","2023-01-26","2023-01-16","2023-04-05","2023-04-05","2023-04-03","2022-10-23","2022-10-23","2022-10-23","2022-10-23","2023-01-19","2023-04-01","2022-10-23","2023-01-16","2023-01-16","2022-10-23","2023-01-15","2022-10-23","2022-12-30","2023-01-16","2022-10-24","2023-01-15","2023-04-01","2023-01-15","2022-02-01","2022-02-01","2022-02-01","2022-02-01","2023-01-19","2023-01-17","2023-01-16","2023-01-16","2023-01-16","2023-01-16","2023-01-16","2023-01-16","2023-01-17","2023-01-17","2023-01-17","2023-01-26","2023-01-26","2022-02-11","2022-02-11","2022-02-11","2022-02-11","2023-04-05","2023-04-01","2023-04-01","2023-04-01","2023-04-01","2023-04-01"],"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":[["","65862001001","METFORMIN","TAB 1000MG","60","Select","Select",""],["","69584009210","BUSPIRONE","TAB 10MG","60","Select","Select",""],["","16729009612","QUETIAPINE","TAB 300MG ER","30","Select","Select",""],["","00228212710","CLONIDINE","TAB 0.1MG","60","Select","Select",""],["","57237018090","PRAMIPEXOLE","TAB 0.125MG","90","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","57237001830","DULOXETINE","CAP 30MG","90","Select","Select",""],["","72205001390","PREGABALIN","75 MG","60","Select","Select",""],["","00904699860","DOCUSATE SOD","CAP 100MG","60","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00093720198","PRAVASTATIN","TAB 20MG","90","Select","Select",""],["","64380073706","VITAMIN D","CAP 50000UNT","2","Select","Select",""],["","63736012301","VITRON-C","TAB 65-125","30","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA","100","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","100","Select","Select",""],["","00185067601","HYDROXYZ PAM","CAP 50MG","60","Select","Select",""],["","16714040101","CEFUROXIME","TAB 500MG","10","Select","Select",""],["","16571066401","METRONIDAZOL","TAB 500MG","15","Select","Select",""],["","65862056090","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","08627001601","DEXCOM G6","MIS TRANSMIT","1","Select","Select",""],["","65862064230","AZITHROMYCIN","500 MG","3","Select","Select",""],["","16714047802","AMOX\/K CLAV","TAB 875-125","14","Select","Select",""],["","49100036374","CULTURELLE","CAP IMMUNITY","20","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","57237000430","FLUCONAZOLE","100 MG","5","Select","Select",""],["","62135043690","SUCRALFATE","1 G","90","Select","Select",""],["","08290324912","VEO INSULIN SYRINGE","31GX15\/64\"","10","Select","Select",""],["","68462015713","ONDANSETRON ODT","4 MG","10","Select","Select",""],["","51991074790","DULOXETINE HCL","30 MG","90","Select","Select",""],["","16714055901","PRAVASTATIN SODIUM","20 MG","90","Select","Select",""],["","60432053716","NYSTATIN","100000\/ML","200","Select","Select",""],["","31722057190","LANSOPRAZOLE","30 MG","60","Select","Select",""],["","08627005303","DEXCOM G","6 SENSOR","3","Select","Select",""],["","00904699860","DOCUSATE SODIUM","100 MG","60","Select","Select",""],["","52817018000","CLONIDINE HCL","0.1 MG","60","Select","Select",""],["","43598050930","ESOMEPRAZOLE MAGNESIUM","20 MG","60","Select","Select",""],["","00406055201","OXYCODONE HCL","5 MG","10","Select","Select",""],["","00955172901","INSULIN GLARGINE","100\/ML","10","Select","Select",""],["","67877056305","METFORMIN HCL","1000 MG","180","Select","Select",""],["","16729009612","QUETIAPINE FUMARATE ER","300 MG","90","Select","Select",""],["","00093005401","BUSPIRONE HCL","10 MG","60","Select","Select",""],["","00406012301","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","12","Select","Select",""],["","68382004101","PROMETHAZINE HCL","25 MG","12","Select","Select",""],["","00093220401","METOCLOPRAMIDE HCL","5 MG","20","Select","Select",""],["","60569049412","MAGOX","400 400 MG","10","Select","Select",""],["","00713052612","PROMETHEGAN","25 MG","6","Select","Select",""],["","49100036374","CULTURELLE HEALTH-WELLNESS","15B CELL","60","Select","Select",""],["","00115180401","HYDROXYZINE PAMOATE","50 MG","60","Select","Select",""],["","65862050320","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","10","Select","Select",""],["","11917015018","ULTRA THIN LANCETS","30 GAUGE","300","Select","Select",""],["","56151146001","TRUE METRIX GLUCOSE TEST STRIP","","300","Select","Select",""],["","00406051201","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","4","Select","Select",""],["","56151147002","TRUE METRIX BLOOD GLUCOSE MTR","","1","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":""}]}]}