{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WINDER  B BLYTHER","gend":1,"add":"520 JAMES RD APT 1","city":"PETERSBURG","state":"VA","zip":23803,"dob":"1970-09-06","age":"","mstatus":"","insh":"20024033*01","cliId":"","pno":"804\/291-8431","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"540\/549-1285","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23803,"pcpcounty":"","pcpid":"","pcpname":"FARAZ MASOOD PLLC","plan":"OHP","program":"Medicaid","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/459-1274","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F43.10","F25.1","H91.21","M77.51","E11.9","R06.00","R06.2","Z20.822","U07.1","E87.6","J30.9","J30.1","J45.30","H10.45","G47.33","E66.9","G47.00","R06.83","H91.93","I10.","J45.909","E78.00","Z68.42","Z79.899","Z79.51","Z88.5","F17.210","F33.3","D25.1","N93.9","R06.09","R07.89","N93.8","D25.9","H60.91","R94.31","R30.0","R10.9","J43.9","R60.0","E66.01","Z71.6","D50.8","H73.11","H90.3","Z20.828","R39.81","R15.9","H91.8X3","R06.02","Z86.16","K11.20","Z87.09","H92.01","H91.91","R10.819","Z90.710","Z68.43","F20.9","G47.09","Z23.","E11.65","E78.2","F31.32","Z30.9","Z30.42","Z01.419","F31.9","J98.8","R73.01","D50.9","E88.81","I51.7","J44.9","Z00.00","N91.0","M51.36","F39.","F31.0","F41.1","F33.1","N39.41","Z12.11","NO DATA","J06.9","J45.901","E78.5","F17.200","R05.9","N39.46","R51.9","R42.","I11.9","R35.0","N95.2","E28.39"],"date":["2022-06-21","2020-08-17","2021-01-07","2021-04-19","2021-12-19","2021-05-05","2021-05-05","2022-08-04","2021-05-09","2021-05-09","2022-01-12","2022-01-12","2021-12-01","2021-12-01","2021-12-01","2022-10-25","2021-12-01","2021-12-01","2021-12-19","2022-09-15","2022-10-25","2022-10-25","2021-12-21","2021-12-19","2022-10-25","2022-10-25","2021-12-19","2022-04-25","2020-06-03","2020-06-03","2020-03-10","2020-03-10","2020-06-03","2020-06-03","2020-12-26","2022-08-04","2020-07-14","2020-07-14","2020-10-13","2021-01-06","2020-10-13","2020-09-15","2020-09-15","2021-04-20","2021-04-20","2021-05-19","2021-05-20","2021-05-20","2021-04-09","2021-05-09","2021-06-15","2021-12-21","2021-12-21","2021-12-21","2021-12-21","2020-09-21","2022-11-21","2022-10-25","2021-04-05","2021-04-05","2021-07-19","2022-04-22","2022-04-22","2019-04-14","2019-02-18","2019-05-06","2019-10-14","2022-04-22","2019-07-09","2019-07-09","2019-07-09","2019-10-31","2019-10-31","2019-12-23","2019-05-31","2019-05-31","2019-11-29","2019-02-11","2019-03-27","2019-03-27","2022-09-01","2022-09-15","2022-09-15","2022-09-15","2022-08-04","2022-08-04","2022-08-04","2022-08-04","2022-08-04","2022-11-21","2022-08-04","2022-10-25","2022-10-25","2022-10-31","2022-10-31","2022-10-31"],"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":[]},{"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":[["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","","HYDROXYZ"," HYDROXYZ ","30","Select","Select",""],["","66993007996","FLUTICAS","AER 110MCG","12","Select","Select",""],["","68382025601","OXYBUTYNIN","TAB 10MG ER","30","Select","Select",""],["","00173071920","FLOVENT","AER 110MCG","12","Select","Select",""],["","","METFORMIN","TAB 500MG","","Select","Select",""],["","","PRAVASTATIN"," PRAVASTATIN ","30","Select","Select",""],["","","LOSARTAN\/HCT"," LOSARTAN\/HCT ","30","Select","Select",""],["","","METOPROL"," METOPROL ","60","Select","Select",""],["","","CLONIDINE"," CLONIDINE ","60","Select","Select",""],["","69097083512","SERTRALINE","TAB 100MG","30","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","10","Select","Select",""],["","","MONTELUKAST"," MONTELUKAST ","30","Select","Select",""],["","80681017000","VITAMIN","TAB 50MCG","30","Select","Select",""],["","00536105227","PEG3350","POW ","510","Select","Select",""],["","70954001910","PRAZOSIN","CAP 1MG","30","Select","Select",""],["","","ONETOUCH","TES VERIO","","Select","Select",""],["","","AMLODIPINE"," AMLODIPINE ","30","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","16729028515","ROSUVASTATIN","TAB 10MG","30","Select","Select",""],["","60003012556","SAFETY","MIS LANCETS","100","Select","Select",""],["","49348014392","SM","POW ","510","Select","Select",""],["","00093083205","CLONAZEPAM","TAB 0.5MG","30","Select","Select",""],["","","ESTRADIOL","TAB 1MG","","Select","Select",""],["","16571066101","MECLIZINE","TAB 25MG","30","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","15","Select","Select",""],["","72217000605","PEN  NEEDLES","MIS 32GX3\/16","100","Select","Select",""],["","00002771459","HUMALOG","INJ 100\/ML","15","Select","Select",""],["","","METOPROLOL","TAB 50MG ER","","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","","ATORVASTATIN","TAB 10MG","","Select","Select",""],["","","ANORO","AER 62.5-25","","Select","Select",""],["","","TRELEGY","AER ELLIPTA","","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","180","Select","Select",""],["","49884072505","BUSPIRONE","TAB 7.5MG","60","Select","Select",""],["","72647033104","METHYLPRED","TAB 4MG","21","Select","Select",""],["","43547030303","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","65162068090","PROMETHAZINE","SOL DM","118","Select","Select",""],["","24658031205","DOXYCYCL","TAB 100MG","20","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","21","Select","Select",""],["","00115169449","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","28","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","30","Select","Select",""],["","50428042388","MELATONIN","CAP 10MG","30","Select","Select",""],["","08373747800","OPTICHAMBER","MIS DIAMOND","1","Select","Select",""],["","42135010000","COMPACT","MIS CHAMBER","1","Select","Select",""],["","65862020399","LOSARTAN","TAB 100MG","30","Select","Select",""],["","67877025001","QUETIAPINE","TAB 100MG","30","Select","Select",""],["","00904759180","FERROUS","TAB 325MG","15","Select","Select",""],["","00085461001","DULERA","AER 200-5MCG","13","Select","Select",""],["","69315015510","HYDROCHLOROT","TAB 12.5MG","30","Select","Select",""],["","00536106210","STOOL","CAP 100MG","30","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","","RISPERIDONE","TAB 0.5MG","","Select","Select",""],["","49884028901","MEGESTROL","TAB 20MG","42","Select","Select",""],["","68462030529","NORETHINDRON","TAB 0.35MG","84","Select","Select",""],["","","HYDRALAZINE","TAB 10MG","","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","","BUPROPN","TAB 300MG XL","","Select","Select",""],["","","LAMOTRIGINE","TAB 25MG","","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","Select","Select",""],["","","NEO\/POLY\/HC","SUS 1% OTIC","","Select","Select",""],["","","MELOXICAM","TAB 7.5MG","","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}