{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RONALD F BROWN","gend":0,"add":"2312 INGRAM AVE","city":"RICHMOND","state":"VA","zip":"23224-9998","dob":"1953-11-23","age":"","mstatus":"","insh":"900037453*01","cliId":"","pno":"804\/397-2542","cno":"","email":"","ename":"","eno":"","pphy":"AKBAR, SALMAN MD","ppno":"804\/330-5452","pcpadd":"909 HIOAKS RD STE F\/G","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23225,"pcpcounty":"","pcpid":"","pcpname":"SALMAN M AKBAR MD","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/337-9950","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M51.16","M51.27","M48.07","C18.9","M19.90","G47.00","E55.9","R73.09","M54.16","M54.17","G89.4","M51.37","F11.21","R39.81","M62.81","I10.","M54.5","K21.9","E11.42","E78.5","J43.9","F10.20","M54.9","R82.5","R42.","R07.89","K59.00","R06.02","E11.9","F17.200","R10.9","Z12.11","R94.6","R68.89","R19.5","G62.9","M48.00","R06.09","M25.561","M51.17"],"date":["2020-01-23","2020-01-23","2020-01-23","2021-04-13","2021-06-01","2021-08-25","2021-08-25","2021-08-25","2021-11-10","2021-11-24","2021-11-24","2021-11-24","2021-06-24","2020-10-29","2020-10-29","2021-08-25","2021-08-25","2021-06-24","2021-06-24","2021-06-24","2021-06-24","2021-06-24","2021-03-05","2021-09-23","2020-02-23","2020-02-23","2020-02-23","2020-02-23","2021-02-16","2020-02-23","2020-02-23","2020-07-23","2020-10-12","2020-10-12","2021-04-28","2020-10-19","2021-09-23","2021-09-23","2021-09-23","2020-01-23"],"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":[]}]},{"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":[["","57664022388","OXYCODONE HYDROCHLORIDE ","5MG","90","Select","Select",""],["","00115127901","MORPHINE SULFATE ER ","50MG ER","30","Select","Select",""],["","00093720198","PRAVASTATIN SODIUM ","20MG","30","Select","Select",""],["","00591565810","CYCLOBENZAPRINE HYDROCHLORIDE ","10MG","60","Select","Select",""],["","51645075099","DOCUSATE SODIUM ","100MG","180","Select","Select",""],["","65862020390","LOSARTAN POTASSIUM ","100MG","90","Select","Select",""],["","00054017613","BUPRENORPHINE HCL ","2MG","-4","Select","Select",""],["","00054018913","BUPRENORPHINE HCL\/NALOXONE HCL ","8-2MG","90","Select","Select",""],["","75987004005","PENNSAID ","2%","112","Select","Select",""],["","69452015120","VITAMIN D ","50000UNT","4","Select","Select",""],["","50111043301","TRAZODONE HYDROCHLORIDE ","50MG","45","Select","Select",""],["","08290328466","BD INSULIN SYRINGE ULTRA-FINE\/0.5ML\/30G X 12.7MM ","0.5\/30G","100","Select","Select",""],["","65862039010","ONDANSETRON ODT ","4MG ODT","15","Select","Select",""],["","45802086866","POLYETHYLENE GLYCOL 3350 ","3350 NF","10","Select","Select",""],["","12496120803","SUBOXONE ","8-2MG","90","Select","Select",""],["","65162044210","MECLIZINE HYDROCHLORIDE ","25MG","20","Select","Select",""],["","47781035703","BUPRENORPHINE HYDROCHLORIDE\/NALOXONE HYDROCHLORIDE ","8-2MG","-90","Select","Select",""],["","57664047758","METOPROLOL TARTRATE ","50MG","180","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA ","HFA","8","Select","Select",""],["","50428050854","CVS PURELAX ","","10","Select","Select",""],["","55111015810","OMEPRAZOLE ","20MG","30","Select","Select",""],["","68180072103","AMLODIPINE BESYLATE ","10MG","30","Select","Select",""],["","51991074790","DULOXETINE HCL ","30MG","30","Select","Select",""],["","58160082311","SHINGRIX ","50\/0.5ML","1","Select","Select",""],["","65162083366","DICLOFENAC SODIUM ","1%","100","Select","Select",""],["","68382076010","METFORMIN HYDROCHLORIDE ","1000MG","60","Select","Select",""],["","70461032003","FLUCELVAX QUADRIVALENT 2020-2021 ","2020-21","0","Select","Select",""],["","59651000305","OMEPRAZOLE DR ","40MG","90","Select","Select",""],["","00002880559","HUMULIN N KWIKPEN ","U-100KWP","60","Select","Select",""],["","00002880359","HUMULIN 70\/30 KWIKPEN ","70\/30KWP","-60","Select","Select",""],["","00555032402","HYDROXYZINE PAMOATE ","100MG","30","Select","Select",""],["","69097015907","MELOXICAM ","15MG","30","Select","Select",""],["","59746000103","METHYLPREDNISOLONE DOSE PACK ","4MG","21","Select","Select",""],["","00603459321","METHYLPREDNISOLONE ","4MG","21","Select","Select",""],["","16729018201","HYDROCHLOROTHIAZIDE ","12.5MG","30","Select","Select",""],["","00093310905","AMOXICILLIN ","500MG","21","Select","Select",""],["","60505025203","TIZANIDINE HYDROCHLORIDE ","4MG","-180","Select","Select",""],["","52268001201","SUPREP BOWEL PREP KIT ","PREP KIT","-354","Select","Select",""],["","56151146001","TRUE METRIX BLOOD GLUCOSETEST STRIPS ","GLUCOSE","100","Select","Select",""],["","38396030576","CVS LANCETS ULTRA-THIN 30G ","30G","100","Select","Select",""],["","50742061610","METOPROLOL SUCCINATE ER ","50MG ER","60","Select","Select",""],["","49884012201","LABETALOL HYDROCHLORIDE ","100MG","-60","Select","Select",""],["","43598029190","PREGABALIN ","25MG","-90","Select","Select",""],["","56151149002","TRUE METRIX AIR BLOOD GLUCOSE METER\/BLUETOOTH SMART ","AIR","1","Select","Select",""],["","49483060250","IBUPROFEN ","400MG","20","Select","Select",""],["","70461012103","FLUAD QUADRIVALENT 2021-2022 ","2021-22","0","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":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}