{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CRYSTAL  S POWELL","gend":1,"add":"1043 SUNSET LN","city":"HALIFAX","state":"VA","zip":"24558-9998","dob":"1981-02-25","age":"","mstatus":"","insh":"9005587*01","cliId":"","pno":4344710220,"cno":4344710220,"email":"","ename":"","eno":"","pphy":"CORBETT, TIMOTHY W MD","ppno":4343929366,"pcpadd":"324 COMMERCE ROAD","pcpcity":"FARMVILLE","pcpstate":"VA","pcpzip":"23901-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4343929348,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","K59.09","G40.909","D68.51","F31.9","R39.15","N32.81","R11.2","K22.2","R10.84","K22.70","K58.9","R13.19","K21.9","R14.0","Z01.89","Z01.810","Z01.812","K59.00","R10.9","G89.29","G47.00","Z76.0","I10.","J02.0","J02.9","R05.1","R00.2","R07.89","E55.9","J30.9","K44.9","G56.02","R60.0","T14.8XXA","R06.00","J98.01","R05.3","G47.33","F17.200","NO DATA","R06.02","I49.1","I49.3","M79.641","J01.90","E78.5","K57.90","J44.9","I11.9","R73.02","E66.09","Z20.822","K59.04","M79.604","M79.7","F79.","F17.210","Z88.6","Z91.014","Z91.041","Z91.011","Z88.5","Z91.09","Z79.899","Z20.828","K58.1","R06.09","R29.90","R09.89","Z01.419","M79.605","K86.81","R11.0","R06.83","L20.9","K29.70","F41.9","E66.9","Z68.31","G47.30","F19.10","E11.9","K29.00","R10.10"],"date":["2023-04-14","2023-03-14","2023-02-13","2023-02-16","2023-02-13","2021-03-19","2021-06-17","2022-09-13","2022-09-13","2022-09-13","2021-06-25","2022-09-13","2021-08-04","2022-09-13","2022-09-13","2021-07-30","2022-02-03","2022-02-11","2021-11-24","2022-09-13","2021-11-24","2022-04-12","2023-04-14","2023-03-14","2022-12-24","2022-08-27","2022-08-27","2023-01-17","2023-02-10","2022-12-15","2021-12-14","2021-12-14","2022-02-16","2022-08-16","2022-06-13","2022-11-23","2022-11-23","2022-11-23","2022-11-23","2022-11-23","2023-02-16","2023-02-16","2023-02-16","2023-02-16","2022-12-15","2023-03-14","2023-04-14","2023-03-14","2023-03-14","2022-09-01","2022-09-01","2021-01-14","2022-02-11","2022-09-13","2021-09-17","2022-02-16","2022-02-16","2022-02-16","2022-02-16","2022-02-16","2022-02-16","2022-02-16","2022-02-16","2022-02-16","2022-02-16","2022-12-24","2022-09-13","2023-01-10","2023-01-05","2023-01-05","2021-02-15","2021-10-15","2021-11-15","2021-10-15","2022-10-02","2021-07-16","2021-08-04","2021-08-04","2021-08-04","2021-08-04","2021-08-04","2022-01-14","2023-01-10","2021-08-04","2021-08-04"],"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":[["","64764017530","DEXILANT","CAP 60MG DR","60","Select","Select",""],["","00456120230","LINZESS","CAP 290MCG","30","Select","Select",""],["","12496120803","SUBOXONE","8 MG-2 MG","60","Select","Select",""],["","65862024708","LEVETIRACETA","TAB 750MG","120","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","42806054701","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","70377000812","ROSUVASTATIN","TAB 20MG","30","Select","Select",""],["","47781035703","BUPREN\/NALOX","MIS 8-2MG","60","Select","Select",""],["","65862022801","LAMOTRIGINE","TAB 100MG","60","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","400","Select","Select",""],["","59779030603","CVS PURELAX","POW ","510","Select","Select",""],["","57237001401","TAMSULOSIN","CAP 0.4MG","90","Select","Select",""],["","00254302902","LUBIPROSTONE","CAP 24MCG","60","Select","Select",""],["","65862050220","AMOX\/K CLAV","TAB 500-125","20","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00121087316","LACTULOSE","SOL 10GM\/15","450","Select","Select",""],["","54092054701","MOTEGRITY","TAB 2MG","30","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","60","Select","Select",""],["","33342032815","TRIAMCINOLON","CRE 0.005","15","Select","Select",""],["","68382025501","OXYBUTYNIN","TAB 5MG ER","30","Select","Select",""],["","00032301613","CREON","CAP 36000UNT","180","Select","Select",""],["","24979070406","DEXLANSOPRAZ","CAP 60MG DR","60","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","18","Select","Select",""],["","50742061510","METOPROL SUC","TAB 25MG ER","30","Select","Select",""],["","00603533815","PREDNISONE","PAK 10MG","21","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","20","Select","Select",""],["","43386031214","GAVILAX","17 G\/DOSE","510","Select","Select",""],["","41100082071","MIRALAX","POW 3350 NF","510","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","59779030603","PURELAX","17 G\/DOSE","510","Select","Select",""],["","24979070406","DEXLANSOPRAZOLE DR","60 MG","60","Select","Select",""],["","65862039010","ONDANSETRON ODT","4 MG","20","Select","Select",""],["","47781035703","BUPRENORPHINE-NALOXONE","8 MG-2 MG","60","Select","Select",""],["","68382056410","METOPROLOL SUCCINATE","25 MG","30","Select","Select",""],["","00143122701","DICYCLOMINE HCL","20 MG","60","Select","Select",""],["","69097014260","ALBUTEROL SULFATE HFA","90 MCG","6.7","Select","Select",""],["","70377000812","ROSUVASTATIN CALCIUM","20 MG","30","Select","Select",""],["","00143924920","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","20","Select","Select",""],["","00310461612","BREZTRI AEROSPHERE","160-9-4.8","10.7","Select","Select",""],["","45802086803","POLYETHYLENE GLYCOL","3350 17 G\/DOSE","510","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":""}]}]}