{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CAROL   J MINNIS","gend":1,"add":"2309 CERSLAY ST","city":"RICHMOND","state":"VA","zip":"23224-9998","dob":"1958-04-02","age":"","mstatus":"","insh":"900041456*01","cliId":"","pno":"804\/496-8684","cno":"","email":"","ename":"","eno":"","pphy":"JOSEPH, LERLA G MD","ppno":"804\/230-4913","pcpadd":"1606 HULL ST RD","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23224,"pcpcounty":"","pcpid":"","pcpname":"CHARLES CITY MEDICAL GROUP INC","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"N","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/233-1841","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D57.1","I10.","E11.9","F90.0","Z79.899","G89.29","Z12.31","Z12.11","Z13.39","Z13.9","G89.4","Z12.39","Z12.4","Z12.12","M17.12","Z78.9","Z13.31","F90.9","Z79.891","E78.5","M25.559"],"date":["2021-10-26","2021-08-27","2021-09-24","2021-10-26","2021-11-29","2021-02-24","2021-02-24","2021-05-23","2021-10-26","2021-02-24","2021-09-24","2021-05-26","2021-05-26","2021-05-26","2021-09-24","2021-10-26","2021-10-26","2020-07-31","2020-06-03","2021-07-23","2020-07-31"],"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":[["","00054457125","METHADONE HCL                                                         ","10MG","600","Select","Select",""],["","10702010201","METHYLPHENIDATE HYDROCHLORIDE                                         ","20MG","90","Select","Select",""],["","00054071025","METHADONE HYDROCHLORIDE                                               ","10MG","600","Select","Select",""],["","00169750111","NOVOLOG                                                               ","100\/ML","10","Select","Select",""],["","42858010401","OXYCODONE\/ACETAMINOPHEN                                               ","10-325MG","240","Select","Select",""],["","08560940003","V-GO 20                                                               ","","-90","Select","Select",""],["","68382076010","METFORMIN HYDROCHLORIDE                                               ","1000MG","-180","Select","Select",""],["","68180021509","LOSARTAN POTASSIUM\/HYDROCHLOROTHIAZIDE                                ","50-12.5","90","Select","Select",""],["","70377002911","ATORVASTATIN CALCIUM                                                  ","40MG","90","Select","Select",""],["","65862085901","FAMOTIDINE                                                            ","20MG","180","Select","Select",""],["","00193709021","CONTOUR BLOOD GLUCOSE TEST STRIPS                                     ","BLD GLUC","100","Select","Select",""],["","59779052228","CVS ATHLETES FOOT                                                     ","1%","30","Select","Select",""],["","65162046510","IBUPROFEN                                                             ","600MG","15","Select","Select",""],["","62332025118","AZITHROMYCIN                                                          ","250MG","6","Select","Select",""],["","00169413212","OZEMPIC                                                               ","2\/1.5ML","2","Select","Select",""],["","38779244203","FLUCONAZOLE                                                           ","","5","Select","Select",""],["","00116200116","CHLORHEXIDINE GLUCONATE                                               ","0.12%","473","Select","Select",""],["","08290328438","BD INSULIN SYRINGE ULTRA-FINE\/0.3ML\/31G X 8MM                         ","0.3\/31G","100","Select","Select",""],["","51672128901","NYSTATIN                                                              ","100000","15","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":""}]}]}