{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" KCIREDORREHCRA T ","gend":0,"add":"ON 1173EVA HTR","city":"RICHMOND","state":"VA","zip":23222,"dob":"1959-07-05","age":"","mstatus":"","insh":"23200210*83","cliId":"","pno":"22\/4080510-9","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"804\/232-7876","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23222,"pcpcounty":"","pcpid":"","pcpname":"LEON J BROWN JR MD PC","plan":"OHP","program":"Medicaid","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J45.20","I63.50","E78.00","E11.9","E13.37X9","I10.","I11.9","I67.89","J45.909","G81.94","G81.90","D69.6","R22.2","F17.210","R22.30","Z98.890","Z86.73","E78.5","L72.0","I69.959","J44.9","NO DATA","G89.29","N40.0","F17.200","M21.942"],"date":["2021-03-08","2021-10-11","2021-06-08","2022-08-19","2021-10-11","2022-07-28","2020-01-06","2020-05-11","2021-10-11","2020-01-06","2021-10-11","2021-10-11","2019-09-23","2019-12-04","2019-09-16","2019-10-23","2022-08-19","2022-08-19","2019-09-23","2019-02-01","2022-07-28","2022-08-19","2022-08-19","2022-08-19","2022-08-19","2022-08-19"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","64380080707","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","66993007996","FLUTICAS","AER 110MCG","36","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","55111012390","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","23155010205","METFORMIN","TAB 500MG","30","Select","Select",""],["","00173071920","FLOVENT","AER 110MCG","12","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","9","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","60","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","22","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","21","Select","Select",""],["","00186037220","SYMBICORT","AER 80-4.5","10","Select","Select",""],["","","BUDES\/FORMOT","AER 80-4.5","","Select","Select",""],["","00378932132","WIXELA","AER 250\/50","60","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","00527133001","BACLOFEN","TAB 10MG","30","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","11","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}