{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CARLA   S TRENT","gend":1,"add":"3008 COLUMBIA ST","city":"RICHMOND","state":"VA","zip":"23234-9998","dob":"1973-03-07","age":"","mstatus":"","insh":"20036383*01","cliId":"","pno":"804\/822-9051","cno":"804\/822-9051","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":105617,"pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","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":["N28.1","R10.9","R94.31","M54.5","G89.29","Z79.899","F31.32","F41.1","N39.41","J45.909","F31.9","Z99.3","G82.20","G89.4","N30.21","E11.42","I10.","N32.81","F33.1","N95.1","K21.9","F51.04","B37.2","E11.65","J30.2","E11.9","R11.0","J30.9","N95.9","G43.009","M94.0","G81.90","Z13.31","Z28.21","E11.40","E78.2","L81.9","L81.0","L70.9","R19.5","R19.7","Z20.822","R30.0","N39.0","R39.15"],"date":["2020-01-15","2020-01-15","2020-01-15","2020-12-01","2021-01-25","2021-01-26","2021-08-06","2021-08-06","2021-08-20","2021-08-20","2021-08-20","2021-08-20","2021-08-20","2021-08-20","2021-03-09","2021-07-07","2021-07-07","2021-03-09","2021-01-25","2020-06-24","2020-06-24","2020-06-24","2020-06-24","2021-01-25","2021-01-25","2020-04-09","2020-04-09","2020-04-27","2020-04-09","2020-04-09","2020-04-27","2020-04-27","2020-04-27","2020-04-27","2020-04-27","2021-05-04","2021-03-29","2021-03-29","2021-03-29","2021-05-13","2021-05-13","2021-05-13","2020-02-16","2020-02-16","2020-11-09"],"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":[["","10702000350","PROMETHAZINE ","25MG","180","Select","Select",""],["","13811071910","NITROFURANTN ","100MG","6","Select","Select",""],["","51293081101","PHENAZOPYRID ","200MG","6","Select","Select",""],["","33342007007","OLANZAPINE ","10MG","90","Select","Select",""],["","00363056314","ASPIRIN ","81MG EC","30","Select","Select",""],["","64980027903","GLIPIZIDE ","2.5MG","90","Select","Select",""],["","43598081115","CETIRIZINE ","10MG","30","Select","Select",""],["","00093078710","ATENOLOL ","25MG","180","Select","Select",""],["","59310057922","PROAIR ","","8","Select","Select",""],["","00406052301","OXYCOD\/APAP ","10-325MG","180","Select","Select",""],["","00172392670","DIAZEPAM ","5MG","60","Select","Select",""],["","69238117109","DOXEPIN ","50MG","90","Select","Select",""],["","00116200116","CHLORHEX ","0.12%","473","Select","Select",""],["","53885024450","ONETOUCH ","ULTRA BL","150","Select","Select",""],["","68382050010","OMEPRAZOLE ","40MG","30","Select","Select",""],["","00591352530","LIDOCAINE ","5%","30","Select","Select",""],["","00093317431","ALBUTEROL ","HFA","8","Select","Select",""],["","57237000511","FLUCONAZOLE ","150MG","1","Select","Select",""],["","00187516445","RETIN-A ","0.10%","45","Select","Select",""],["","46581067005","SALONPAS ","PAIN REL","30","Select","Select",""],["","68462013801","OXCARBAZEPIN ","300MG","90","Select","Select",""],["","68382013905","TOPIRAMATE ","50MG","180","Select","Select",""],["","13107000334","MIRTAZAPINE ","30MG","30","Select","Select",""],["","00378462326","ESTRADIOL ","0.1MG","8","Select","Select",""],["","00378808445","TRETINOIN ","0.10%","45","Select","Select",""],["","68462012605","GABAPENTIN ","600MG","90","Select","Select",""],["","00093314705","CEPHALEXIN ","500MG","20","Select","Select",""],["","64380080707","IBUPROFEN ","800MG","15","Select","Select",""],["","43386033001","TRIMETHOPRIM ","100MG","60","Select","Select",""],["","00115164501","NITROFUR ","100MG","20","Select","Select",""],["","65862018601","CLINDAMYCIN ","300MG","14","Select","Select",""],["","65862001305","SERTRALINE ","100MG","90","Select","Select",""],["","72733590102","PRALUENT ","75MG\/ML","2","Select","Select",""],["","00574200802","NYSTOP ","100000","120","Select","Select",""],["","57237007810","ONDANSETRON ","8MG ODT","30","Select","Select",""],["","13668033005","TRAZODONE ","50MG","30","Select","Select",""],["","31722072690","MONTELUKAST ","10MG","90","Select","Select",""],["","0","","","30","Select","Select",""],["","69547035302","NARCAN ","","2","Select","Select",""],["","45802073684","CLINDAMY\/BEN ","1.2-5%","45","Select","Select",""],["","00378210001","LOPERAMIDE ","2MG","8","Select","Select",""],["","46581070001","SALONPAS-HOT ","","30","Select","Select",""],["","33342007007","OLANZAPINE","10MG","90","Select","Select",""],["","10702000350","PROMETHAZINE","25MG","60","Select","Select",""],["","00363056314","ASPIRIN","81MG EC","30","Select","Select",""],["","68462012605","GABAPENTIN","600MG","90","Select","Select",""],["","00378363705","CETIRIZINE","10MG","90","Select","Select",""],["","59310057922","PROAIR","","8","Select","Select",""],["","69238117109","DOXEPIN","50MG","90","Select","Select",""],["","00406052301","OXYCOD\/APAP","10-325MG","180","Select","Select",""],["","00591352530","LIDOCAINE","5%","30","Select","Select",""],["","00093078710","ATENOLOL","25MG","180","Select","Select",""],["","00093317431","ALBUTEROL","HFA","8","Select","Select",""],["","68382050010","OMEPRAZOLE","40MG","30","Select","Select",""],["","00172392670","DIAZEPAM","5MG","60","Select","Select",""],["","57237000511","FLUCONAZOLE","150MG","1","Select","Select",""],["","46581070001","SALONPAS-HOT","","30","Select","Select",""],["","00187516445","RETIN-A","0.10%","45","Select","Select",""],["","53885024450","ONETOUCH","ULTRA BL","50","Select","Select",""],["","68462013801","OXCARBAZEPIN","300MG","90","Select","Select",""],["","13107000334","MIRTAZAPINE","30MG","90","Select","Select",""],["","00378462326","ESTRADIOL","0.1MG","24","Select","Select",""],["","64980027903","GLIPIZIDE","2.5MG","30","Select","Select",""],["","00378808445","TRETINOIN","0.10%","45","Select","Select",""],["","68382013905","TOPIRAMATE","50MG","60","Select","Select",""],["","00093314705","CEPHALEXIN","500MG","20","Select","Select",""],["","51293081001","PHENAZOPYRID","100MG","6","Select","Select",""],["","43386033001","TRIMETHOPRIM","100MG","30","Select","Select",""],["","00115164501","NITROFUR","100MG","20","Select","Select",""],["","65862018601","CLINDAMYCIN","300MG","14","Select","Select",""],["","00116200116","CHLORHEX","0.12%","473","Select","Select",""],["","64380080707","IBUPROFEN","800MG","15","Select","Select",""],["","65862001305","SERTRALINE","100MG","30","Select","Select",""],["","00574200802","NYSTOP","100000","120","Select","Select",""],["","13668033005","TRAZODONE","50MG","30","Select","Select",""],["","72733590102","PRALUENT","75MG\/ML","2","Select","Select",""],["","69547035302","NARCAN","","2","Select","Select",""],["","00185012201","NITROFURANTN","100MG","20","Select","Select",""],["","45802073684","CLINDAMY\/BEN","1.2-5%","45","Select","Select",""],["","00054025913","MONTELUKAST","10MG","90","Select","Select",""],["","57237007810","ONDANSETRON","8MG ODT","30","Select","Select",""],["","00378210001","LOPERAMIDE","2MG","8","Select","Select",""],["","16110086950","AZELEX","20%","50","Select","Select",""],["","45802046564","KETOCONAZOLE","2%","240","Select","Select",""],["","68462034690","LEVOCETIRIZI","5MG","30","Select","Select",""],["","46581067005","SALONPAS","PAIN REL","30","Select","Select",""],["","16571020150","DICLOFENAC","75MG DR","30","Select","Select",""],["","52817033200","CYCLOBENZAPR","10MG","30","Select","Select",""],["","68462034690","LEVOCETIRIZI ","TAB 5MG","90","Select","Select",""],["","16110086950","AZELEX ","CRE 0.2","50","Select","Select",""],["","52817033200","CYCLOBENZAPR ","TAB 10MG","30","Select","Select",""],["","45802046564","KETOCONAZOLE ","SHA 0.02","240","Select","Select",""],["","00173071820","FLOVENT ","AER 44MCG","11","Select","Select",""],["","16571020150","DICLOFENAC ","TAB 75MG DR","30","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":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","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":""}]}]}