{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" BERTRAM A PRYOR BATTLE","gend":0,"add":"119 E LEIGH ST","city":"RICHMOND","state":"VA","zip":"23219-9998","dob":"1962-04-18","age":"","mstatus":"","insh":"900039081*01","cliId":"","pno":"804\/714-7961","cno":"804\/714-7961, ","email":"","ename":"","eno":"","pphy":"HUYNH, CHRISTINE MD","ppno":"804\/628-4455","pcpadd":"417 NORTH 11TH ST","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23298,"pcpcounty":"","pcpid":670982,"pcpname":"","plan":"OHP - OPTIMA","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"804\/714-7961, ","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":["E83.119","N18.9","B20.","N28.9","I10.","E78.5","K21.9","Z79.899","C22.0","B18.1","R91.8","J43.8","J43.2","I51.7","I25.10","I48.91","Z86.19","E83.42","I12.9","N18.3","M85.9","Z87.891","I42.9","I49.3","K52.9","R19.7","Z01.812","K76.9","B19.10","K91.870","N18.2","F41.9","Z21.","Y83.8","Z88.0","Z88.2","Z12.11","I49.1","N18.30","R00.2","K76.89","N28.89","Z90.49","Z90.89","Z45.2","J90.","R05.","M47.814","M41.9","R68.82","E83.110","R79.89","R55.","H93.19","H93.8X9","H91.90","R42.","Z83.49","Z86.59","M54.12","R09.82","B18.2","R49.0","R13.10","N28.1","K91.840","R52.","I48.0","I35.1","I70.0","I51.89","I47.1","R00.8","B19.20","E88.89","K76.0","K31.89","D35.02","C22.1","K82.8","F31.9"],"date":["2020-11-30","2021-03-30","2021-04-22","2020-10-14","2021-04-08","2021-04-08","2021-03-30","2021-04-08","2021-03-30","2021-02-16","2021-03-12","2021-03-12","2021-03-12","2021-05-13","2021-03-12","2021-04-19","2021-01-12","2021-03-30","2021-03-23","2020-09-16","2020-09-16","2021-03-23","2021-01-26","2020-10-26","2021-05-13","2021-02-05","2021-03-12","2021-03-12","2021-03-23","2021-03-23","2021-03-23","2021-03-30","2021-03-23","2021-03-23","2021-03-23","2021-03-23","2020-07-23","2020-09-29","2021-01-26","2021-01-26","2021-04-28","2021-03-23","2021-03-23","2021-04-22","2021-03-23","2021-03-23","2021-03-30","2020-06-24","2020-06-24","2020-08-12","2020-11-30","2020-11-30","2021-03-12","2020-11-30","2020-11-30","2020-11-30","2020-11-30","2020-11-30","2020-11-30","2021-03-30","2021-03-30","2021-03-23","2020-11-03","2020-11-03","2021-04-28","2021-03-25","2020-06-29","2021-03-12","2020-10-21","2020-10-21","2020-10-21","2020-10-26","2020-10-26","2020-12-23","2020-12-23","2021-04-28","2021-04-28","2021-04-28","2021-05-13","2021-03-23","2021-06-07"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"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":[]}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","3089421","ELIQUIS","TAB 5MG","-60","Select","Select",""],["","49702023113","TRIUMEQ","TAB ","90","Select","Select",""],["","69315090510","LORAZEPAM","TAB 1MG","30","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","79854007941","VITAMIN D3","TAB 5000UNIT","60","Select","Select",""],["","781286810","OMEPRAZOLE","CAP 20MG","-30","Select","Select",""],["","65162003310","APAP\/CODEINE","TAB 300-30MG","24","Select","Select",""],["","67877019805","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","7610017840","VITAMIN D-3","TAB 5000UNIT","30","Select","Select",""],["","65862084230","ENTECAVIR","TAB 1MG","90","Select","Select",""],["","904423960","MAGNESIUM","TAB 500MG","360","Select","Select",""],["","60505265401","TRAZODONE","TAB 100MG","-60","Select","Select",""],["","60432026415","FLUTICASONE","SPR 50MCG","-16","Select","Select",""],["","87701040752","GNP VIT D","TAB 5000UNIT","60","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","-1","Select","Select",""],["","31722072990","IRBESARTAN","TAB 75MG","90","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","-90","Select","Select",""],["","61314054701","LATANOPROST","SOL 0.00005","8","Select","Select",""],["","57896020401","ACETAMINOPHE","TAB 500MG","28","Select","Select",""],["","406324301","HYDROMORPHON","TAB 2MG","12","Select","Select",""],["","135057602","FLONASE ALGY","SPR 50MCG","10","Select","Select",""],["","378036001","NIFEDIPINE","TAB 60MG ER","-60","Select","Select",""],["","68382009505","CARVEDILOL","TAB 25MG","60","Select","Select",""],["","50742061501","METOPROL SUC","TAB 25MG ER","90","Select","Select",""],["","70461032003","FLUCLVX QUAD","INJ 2020-21","0","Select","Select",""],["","49702023113","TRIUMEQ ","","30","Select","Select",""],["","60505265301","TRAZODONE HYDROCHLORIDE","","30","Select","Select",""],["","55111015330","ONDANSETRON HYDROCHLORIDE ","","90","Select","Select",""],["","591024110","LORAZEPAM ","","30","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","","18","Select","Select",""],["","87701040752","GNP VITAMIN D SUPER STRENGTH","","60","Select","Select",""],["","65862084230","ENTECAVIR ","","90","Select","Select",""],["","135057602","FLONASE ALLERGY RELIEF","","10","Select","Select",""],["","60432026415","FLUTICASONE PROPIONATE","","-16","Select","Select",""],["","67877019910","AMLODIPINE BESYLATE","","90","Select","Select",""],["","904423960","MAGNESIUM ","","540","Select","Select",""],["","70461032003","FLUCELVAX QUADRIVALENT 2020-2021","","0","Select","Select",""],["","50428043715","CVS MAGNESIUM ","","360","Select","Select",""],["","50742061501","METOPROLOL SUCCINATE ER","","90","Select","Select",""],["","65162003310","ACETAMINOPHEN\/CODEINE PHOSPHATE ","","24","Select","Select",""],["","57896020401","ACETAMINOPHEN EXTRA STRENGTH","","28","Select","Select",""],["","65162083366","DICLOFENAC SODIUM","","100","Select","Select",""],["","7610017840","NATURAL VITAMIN D-3","","30","Select","Select",""],["","3089421","ELIQUIS ","","60","Select","Select",""],["","406324301","HYDROMORPHONE HCL","","12","Select","Select",""],["","378036001","NIFEDIPINE ER ","","-60","Select","Select",""],["","55111015330","ONDANSETRON HYDROCHLORIDE","","-90","Select","Select",""],["","50428043715","CVS MAGNESIUM","","360","Select","Select",""],["","65162003310","ACETAMINOPHEN\/CODEINE PHOSPHATE","","24","Select","Select",""],["","62175026137","NIFEDIPINE ER","","60","Select","Select",""],["","16729007329","CAPECITABINE","","84","Select","Select",""],["","59762045001","COLESTIPOL HCL","","120","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}