{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LISA JAMERSON","gend":1,"add":"193 CHATELAINE AVE APT D","city":"DANVILLE","state":"VA","zip":"24541-9998","dob":"1978-07-02","age":"","mstatus":"","insh":"7887833*01","cliId":"","pno":4347138284,"cno":4347138284,"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 - Brosville","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":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G43.019","G44.201","F33.1","F31.9","I10.","E78.5","R10.32","E66.9","Z76.89","Z12.31","Z86.73","M54.5","M54.81","G47.00","G47.33","NO DATA","D50.9","I25.2","K21.9","M79.671","I25.10","I20.9","E66.3","I25.119","M54.12","I35.1","I44.4","R94.31","N20.1","N39.0","L28.1","L29.8","L85.3","D22.72","R07.9","Z88.5","R94.39","M54.16","M51.36","G89.29","G56.03","M25.512","M47.812","Z87.891","I36.1","I37.1","F41.1","T68.XXXA","R52.","M54.89","S39.012A","Y99.9","Z01.810","R06.02","E66.01","Z12.39","N20.0","Z11.59","I34.0","N13.0","N20.2","E44.1","N10.","Z68.41","E87.6","D64.9","G40.909","G43.809","Z90.49","Z28.310","N13.2","R06.09","Z87.442","N32.81","R31.29","R80.9","I20.1","I25.5"],"date":["2023-08-30","2023-08-30","2023-05-25","2023-08-30","2023-05-15","2023-01-27","2021-07-13","2023-05-15","2021-07-13","2021-07-13","2023-01-27","2021-08-19","2023-05-25","2023-04-26","2023-02-20","2023-09-25","2023-01-27","2023-09-25","2023-01-27","2023-01-27","2022-11-29","2022-09-13","2022-11-07","2022-09-29","2023-08-30","2022-11-29","2022-11-29","2022-11-29","2022-09-29","2021-02-17","2022-01-11","2022-01-11","2022-01-11","2022-01-11","2022-10-05","2022-09-28","2022-10-05","2022-11-07","2022-11-07","2022-11-07","2022-11-07","2022-11-07","2022-11-07","2022-11-07","2022-10-13","2022-10-13","2023-01-23","2021-02-17","2021-02-17","2021-02-17","2021-05-11","2021-05-11","2022-09-08","2022-09-08","2023-09-25","2022-10-25","2023-05-01","2022-01-14","2022-08-22","2022-09-29","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2022-09-28","2021-06-21","2023-05-15","2023-05-01","2023-05-01","2023-05-15","2023-09-25","2023-09-25"],"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":[["","00002143611","EMGALITY","INJ 120MG\/ML","1","Select","Select",""],["","24979002702","DILTIAZEM","24HR ER (CD) 180 MG","30","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","28","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","15","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","15","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","18","Select","Select",""],["","65862059805","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","60505258009","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","90","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","23155050110","HYDROXYZ HCL","TAB 25MG","60","Select","Select",""],["","69097012212","TOPIRAMATE","TAB 25MG","60","Select","Select",""],["","79854000615","MELATONIN","5 MG","30","Select","Select",""],["","47335038283","DULOXETINE","CAP 30MG","30","Select","Select",""],["","00603533831","PREDNISONE","PAK 10MG","48","Select","Select",""],["","72888008000","TRAMADOL HCL","50 MG","28","Select","Select",""],["","67877025180","TRIAMCINOLON","CRE 0.001","80","Select","Select",""],["","00172409660","BACLOFEN","TAB 10MG","90","Select","Select",""],["","59762330403","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","45802049326","AMMONIUM LAC","CRE 0.12","385","Select","Select",""],["","67877029605","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","10","Select","Select",""],["","00781286810","OMEPRAZOLE","20 MG","30","Select","Select",""],["","69097084615","CYCLOBENZAPR","TAB 10MG","10","Select","Select",""],["","42192080201","PHENAZOPYRID","TAB 200MG","15","Select","Select",""],["","86227013085","SURE COMFORT","MIS 32GX5\/32","100","Select","Select",""],["","00169280015","SAXENDA","INJ 18MG\/3ML","15","Select","Select",""],["","43547036011","LOSARTAN POT","TAB 25MG","30","Select","Select",""],["","69315090605","LORAZEPAM","TAB 2MG","2","Select","Select",""],["","00143177210","ISOSORB DIN","TAB 20MG","60","Select","Select",""],["","60505258009","ATORVASTATIN CALCIUM","40 MG","90","Select","Select",""],["","00002143611","EMGALITY PEN","120 MG\/ML","1","Select","Select",""],["","43547036011","LOSARTAN POTASSIUM","25 MG","30","Select","Select",""],["","49884005501","IMIPRAMINE HCL","25 MG","30","Select","Select",""],["","00093506101","HYDROXYZINE HCL","25 MG","60","Select","Select",""],["","65862059805","TAMSULOSIN HCL","0.4 MG","30","Select","Select",""],["","00169450514","WEGOVY","0.5MG\/.5ML","2","Select","Select",""],["","64380073706","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","00172572860","FAMOTIDINE","20 MG","60","Select","Select",""],["","69097084615","CYCLOBENZAPRINE HCL","10 MG","30","Select","Select",""],["","00245007111","POTASSIUM CITRATE ER","10 MEQ","60","Select","Select",""],["","24979002702","DILTIAZEM CAP","180MG ER","30","Select","Select",""],["","68180098003","LISINOPRIL TAB","10MG","90","Select","Select",""],["","60505258009","ATORVASTATIN TAB","40MG","90","Select","Select",""],["","45802049326","AMMONIUM LAC CRE","12%","385","Select","Select",""],["","00002143611","EMGALITY INJ","120MG\/ML","1","Select","Select",""],["","69097012212","TOPIRAMATE TAB","25MG","60","Select","Select",""],["","23155050110","HYDROXYZ HCL TAB","25MG","60","Select","Select",""],["","67877029605","IBUPROFEN TAB","800MG","20","Select","Select",""],["","00169280015","SAXENDA INJ","18MG\/3ML","15","Select","Select",""],["","69097084615","CYCLOBENZAPR TAB","10MG","10","Select","Select",""],["","86227013085","SURE COMFORT MIS","32GX5\/32","100","Select","Select",""],["","43547036011","LOSARTAN POT TAB","25MG","30","Select","Select",""],["","65862017760","CEFDINIR CAP","300MG","10","Select","Select",""],["","69315090605","LORAZEPAM TAB","2MG","2","Select","Select",""],["","00781286810","OMEPRAZOLE CAP","20MG","90","Select","Select",""],["","42192080201","PHENAZOPYRID TAB","200MG","15","Select","Select",""],["","00143177101","ISOSORB DIN TAB","10MG","60","Select","Select",""],["","13668010401","ISOSORBIDE MONONITRATE ER","30 MG","90","Select","Select",""],["","27241012502","RANOLAZINE ER","500 MG","60","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":""}]}]}