{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHNITA ANDERSON","gend":1,"add":"4344 MYLAN ROAD","city":"RICHMOND","state":"VA","zip":"23223-9998","dob":"1974-10-22","age":"","mstatus":"","insh":"1691930*01","cliId":"","pno":"804\/241-9297","cno":"","email":"","ename":"","eno":"","pphy":"ROBINSON, TAKISHA MD","ppno":"804\/741-6200","pcpadd":"9600 PATTERSON AVE","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23229,"pcpcounty":"","pcpid":"","pcpname":"PATTERSON AVENUE FAMILY PRACTICE","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/741-6213","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J32.9","Z68.35","R53.83","F41.1","R06.83","R06.81","R07.89","R60.9","E66.8","R68.89","K21.9","M25.561","M17.11","M54.6","G89.29","S40.862A","S40.861A","S80.862A","S80.861A","L03.114","L03.113","L03.116","L03.115","I10.","L29.9","J40.","Z20.822","Z00.00","Z76.89","F41.9","Z91.09","Z87.898","E66.01","Z11.59","Z68.37","G44.209","M54.2","M54.42","M53.9","Z68.36","F32.2","L85.3","J30.89","Z00.01","Z87.892","R00.2","R68.82","Z23.","Z11.4","Z51.81","Z01.419","Z12.39","Z12.12","R21.","W57.XXXD","E87.5","F33.41","K59.09","T78.1XXA","J06.9","S20.369A","W57.XXXA","S80.869A","S40.869A","T78.40XA","R73.03","E55.9","L73.9","J01.00","M54.5","L30.9","S93.602A","M62.838","Z04.9","B34.9","K64.8","R10.84","K59.01","B37.89","Z09.","R09.81","N92.0","D25.9","R23.8","R10.30","F51.05","R13.19","L29.8","M79.672","R40.0","F32.9","Z30.9","N83.201","J11.1","K64.0","R29.898","R06.7","U07.1","R51.9","R07.9","N92.5","Z32.02"],"date":["2021-10-03","2019-10-01","2020-10-29","2021-10-27","2020-12-28","2019-03-15","2021-02-10","2019-03-15","2020-12-28","2019-03-15","2021-05-11","2019-05-21","2019-06-18","2021-12-14","2019-08-19","2019-10-21","2019-10-21","2019-10-21","2019-10-21","2019-10-21","2019-10-21","2019-10-21","2019-10-21","2021-11-23","2019-10-21","2021-03-09","2021-10-03","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-11-09","2021-12-14","2021-12-14","2021-12-14","2021-12-14","2020-05-21","2019-05-14","2020-12-28","2019-09-18","2019-09-18","2021-11-23","2019-09-18","2019-09-18","2019-09-18","2019-09-18","2021-01-28","2021-01-28","2021-01-28","2020-06-29","2019-11-22","2019-11-22","2019-11-22","2019-11-22","2019-01-13","2019-03-06","2019-10-01","2019-10-10","2019-10-01","2019-10-01","2019-11-19","2019-10-08","2019-02-26","2019-11-07","2020-01-19","2020-02-21","2020-02-21","2020-10-19","2020-12-28","2021-10-03","2021-10-03","2019-01-03","2019-01-03","2019-01-03","2019-02-06","2019-03-27","2021-01-18","2021-04-20","2021-01-28","2019-10-10","2019-11-14","2020-05-21","2020-05-21","2020-06-29","2020-10-29","2020-10-29","2020-10-29","2021-04-20","2021-04-20","2019-12-23","2019-01-03","2019-07-31","2021-10-03","2021-03-09","2021-07-07","2021-11-23","2021-11-02","2021-11-02"],"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":[["","00074101756","ORIAHNN","CAP ","56","Select","Select",""],["","75854060203","BALCOLTRA","TAB 0.1-20","28","Select","Select",""],["","68180086413","BLISOVI","TAB FE 1\/20","28","Select","Select",""],["","69584061250","METHOCARBAM","TAB 750MG","30","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","20","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","20","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","70436005901","BUPROPION","TAB 150MG SR","30","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","31722057230","ESOMEPRA","CAP 20MG DR","90","Select","Select",""],["","00143973805","PREDNISONE","TAB 20MG","20","Select","Select",""],["","13668013501","ESCITALOPRAM","TAB 5MG","30","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","30","Select","Select",""],["","37000045502","PRILOSEC","TAB 20MG","14","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","14","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","67253090050","ALPRAZOLAM","TAB 0.25MG","30","Select","Select",""],["","00591565810","CYCLOBENZAPR","TAB 10MG","10","Select","Select",""],["","00143312601","DICYCLOMINE","CAP 10MG","100","Select","Select",""],["","50428689762","SPECTR","TAB HLTH SEN","30","Select","Select",""],["","00472015530","NYSTAT\/TRIAM","OIN ","60","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","45802057178","FEXOFENADINE","TAB 180MG","5","Select","Select",""],["","68382075810","METFORMIN","TAB 500MG","120","Select","Select",""],["","49502050002","EPIPEN","INJ 0.3MG","2","Select","Select",""],["","67877057505","BENZONATATE","CAP 200MG","30","Select","Select",""],["","00093738201","VENLAFAXINE","TAB 75MG","30","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","15","Select","Select",""],["","00430042014","LO","TAB 40188","28","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","68462041827","LIDOCAINE","OIN 0.05","100","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","10702001150","HYDROXYZ","TAB 25MG","20","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","46287000660","SPS","SUS 15GM\/60","120","Select","Select",""],["","10702003645","SOD","POW ","454","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":[]}},{"a":{"indx":["","1"],"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":""}]}]}