{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROCHELLE D KNOWLES","gend":1,"add":"130 FAIRFIELD AVE","city":"DANVILLE","state":"VA","zip":"24541-9998","dob":"1988-10-18","age":"","mstatus":"","insh":"8717869*01","cliId":"","pno":4342510404,"cno":4342510404,"email":"","ename":"","eno":"","pphy":"MCCORMICK, PHYLLIS NP","ppno":4347914122,"pcpadd":"705 MAIN ST,","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24541-9998","pcpcounty":"","pcpid":"","pcpname":"Sovah Family Medical Residency Clinic","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4347914126,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F39.","E55.9","C50.411","Z17.0","F17.210","Z79.899","Z51.11","Z91.89","C77.3","Z92.21","Z20.822","E75.21","F41.9","F32.9","N39.0","C50.911","Z80.0","E28.39","F17.200","R74.01","R11.0","Z51.12","Z45.2","F34.9","R59.0","K12.30","L76.82","Z80.8","Z90.13","Z92.3","R93.89","G89.18","N64.4","N65.0","Z85.3","Z20.828","J06.9","Z76.89","Z71.89","C50.011","F10.129","Z86.73","Z68.24","C50.919","D18.03","K83.8","Z48.3","D72.829","D22.9","R63.4","Z11.52","M89.8X9","G62.0","T45.1X5A","M79.604","M79.605","Z17.1","R45.86","Z98.890","Z48.816","Z40.02","Z40.03","Z98.82","C50.211","Z02.89"],"date":["2023-04-14","2022-02-11","2023-09-20","2023-09-20","2023-01-04","2023-01-09","2022-11-02","2023-07-17","2022-11-30","2022-11-30","2022-11-30","2021-03-25","2023-04-14","2021-12-21","2021-10-07","2023-07-10","2023-01-04","2023-09-20","2023-09-20","2022-12-30","2022-10-19","2023-05-08","2022-11-30","2021-12-10","2022-06-21","2022-08-24","2023-01-04","2023-01-04","2023-04-18","2023-01-09","2022-11-29","2022-11-30","2022-11-30","2023-01-04","2023-03-16","2021-04-22","2021-08-13","2021-11-10","2022-11-08","2023-07-10","2021-04-17","2021-04-17","2021-12-21","2022-07-21","2022-07-21","2022-07-21","2022-11-30","2022-10-19","2022-10-19","2021-03-25","2021-04-22","2022-10-05","2022-10-05","2022-10-05","2023-02-08","2023-02-08","2022-11-08","2023-09-20","2023-09-19","2023-09-19","2023-08-10","2023-08-10","2023-06-08","2023-07-10","2023-07-10"],"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":[["","33342006807","OLANZAPINE","5 MG","30","Select","Select",""],["","13107015790","PAROXETINE","TAB 40MG","30","Select","Select",""],["","75826011510","PHENAZOPYRID","TAB 200MG","9","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","4","Select","Select",""],["","16571041250","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","68682045570","METRONIDAZOL","GEL 0.75%VAG","70","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","30","Select","Select",""],["","0","COMPOUND"," ","150","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","15","Select","Select",""],["","00168035730","LIDO\/PRILOCN","CRE 2.5-2.5%","30","Select","Select",""],["","50428034583","GENTLE LAXAT","SUP 10MG","5","Select","Select",""],["","45802048678","DOCUSATE SOD","CAP 100MG","14","Select","Select",""],["","57896022110","ACETAMIN","TAB 500MG","30","Select","Select",""],["","50428050854","CVS PURELAX","PAK ","14","Select","Select",""],["","68462010630","ONDANSETRON","TAB 8MG","30","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","15","Select","Select",""],["","67877032005","IBUPROFEN","600 MG","30","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","15","Select","Select",""],["","70010077005","METHOCARBAM","TAB 750MG","30","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","42","Select","Select",""],["","50428038612","ACETAMINOPHN","TAB 500MG","60","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","14","Select","Select",""],["","00093747489","CAPECITABINE","500 MG","112","Select","Select",""],["","10702001801","OXYCODONE HCL","5 MG","15","Select","Select",""],["","69097094312","GABAPENTIN","300 MG","60","Select","Select",""],["","13107015790","PAROXETINE HCL","40 MG","90","Select","Select",""],["","67877012405","SILVER SULFADIAZINE","1 %","50","Select","Select",""],["","68682045570","METRONIDAZOLE","0.75 %","70","Select","Select",""],["","00093005805","TRAMADOL HCL","50 MG","12","Select","Select",""],["","00781261301","AMOXICILLIN","500 MG","30","Select","Select",""],["","49483034010","ACETAMINOPHEN","325 MG","60","Select","Select",""],["","57896048914","POLYETHYLENE GLYCOL","3350 17 G\/DOSE","238","Select","Select",""],["","00004110150","XELODA","500 MG","98","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":""}]}]}