{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"STEPHANIE CULL","gend":1,"add":"11247 CHESTER GARDEN CIR","city":"CHESTER","state":"VA","zip":"23831-9998","dob":"1979-01-23","age":"","mstatus":"","insh":"20026040*01","cliId":"","pno":"804\/920-0037","cno":"","email":"","ename":"","eno":"","pphy":"WOOD, TAYLOR J MD","ppno":"804\/828-8786","pcpadd":"417 N 11TH ST","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23298,"pcpcounty":"","pcpid":"","pcpname":"MCV ASSOCIATED PHYSICIANS","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/828-5466","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","Z79.4","E78.5","K21.9","Z79.899","H35.89","G47.33","G25.81","M06.872","M06.871","S92.151A","M08.00","Z51.81","I10.","R00.2","R94.31","Z96.653","Z09.","J45.909","M06.9","V54.16","Z79.82","H35.383","H25.13","M25.571","M25.572","G89.29","E11.65","F17.210","J40.","R50.9","R05.","R06.00","R51.9","R06.02","J30.9","Z87.891","J45.901","S82.61XA","G44.201","J45.20","S69.92XA","S63.695A","M08.042","M65.88","M08.90","R09.02","E66.9","M85.851","W18.30XA","S82.831A","M89.8X6","S82.409A","M25.671","M25.672","R53.1","W19.XXXD","V58.89","Z74.09","E66.01","J02.9","H92.02","Z20.822","M54.2","M25.512","Z23.","H35.52","E11.3293","E11.40","R94.4","Z79.84","N17.9","J06.9","M17.12","R53.83","T84.84XA","M06.89","M25.361","M25.362","M06.00","Z68.41","M08.09","R79.89","R11.10"],"date":["2021-10-08","2021-09-24","2020-05-22","2020-05-22","2021-09-10","2021-09-24","2021-11-09","2021-11-09","2021-10-07","2021-10-07","2021-10-07","2021-09-10","2020-03-09","2021-11-17","2020-10-23","2020-10-23","2020-07-02","2020-07-02","2021-05-07","2021-05-07","2021-10-05","2021-09-10","2021-09-24","2021-09-24","2021-12-15","2021-12-15","2021-12-15","2020-05-22","2020-05-22","2021-04-28","2021-04-09","2021-04-09","2021-04-09","2020-12-21","2021-01-04","2021-01-04","2021-01-04","2021-01-21","2021-08-22","2021-10-08","2020-01-24","2020-02-07","2020-03-09","2020-03-09","2020-04-20","2021-03-11","2020-10-21","2020-10-21","2021-08-22","2021-08-22","2021-09-07","2021-09-07","2021-09-07","2021-11-17","2021-11-17","2021-11-17","2021-11-17","2021-11-17","2021-11-17","2021-11-17","2020-10-12","2020-10-12","2021-03-31","2020-10-14","2020-10-14","2020-10-14","2019-09-06","2019-09-06","2019-10-18","2019-10-18","2019-10-18","2019-11-22","2019-11-22","2019-01-25","2019-04-12","2019-01-25","2019-01-25","2019-04-16","2019-04-16","2019-04-16","2019-04-16","2019-06-06","2019-12-17","2019-12-17"],"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":[["","","VICTOZA"," VICTOZA ","9","Select","Select",""],["","","LANTUS"," LANTUS ","30","Select","Select",""],["","00173071920","FLOVENT","AER 110MCG","12","Select","Select",""],["","","D3"," D3 ","60","Select","Select",""],["","","INSULIN"," INSULIN ","100","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","60","Select","Select",""],["","","ASPIRIN"," ASPIRIN ","30","Select","Select",""],["","","SM","TAB 81MG EC","","Select","Select",""],["","00169430713","RYBELSUS","TAB 7MG","30","Select","Select",""],["","00310653004","BYDUREON","INJ 2MG","4","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX5\/32","200","Select","Select",""],["","","OMEPRAZOLE"," OMEPRAZOLE ","30","Select","Select",""],["","","MEDROXYPR"," MEDROXYPR ","30","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","30","Select","Select",""],["","","CALCIUM"," CALCIUM ","180","Select","Select",""],["","00173088210","BREO","INH 200-25","180","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","00169413602","OZEMPIC","INJ 2\/1.5ML","3","Select","Select",""],["","00574060801","FERROUS","TAB 324MG EC","30","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","","GABAPENTIN"," GABAPENTIN ","60","Select","Select",""],["","00603254421","BUT\/APAP\/CAF","TAB ","20","Select","Select",""],["","","ONETOUCH"," ONETOUCH ","1","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","31","Select","Select",""],["","","XELJANZ"," XELJANZ ","30","Select","Select",""],["","00002143480","TRULICITY","INJ 1.5\/0.5","2","Select","Select",""],["","","OYSTER"," OYSTER ","60","Select","Select",""],["","","ALLERGY","TAB 10MG","","Select","Select",""],["","","METFORMIN"," METFORMIN ","30","Select","Select",""],["","","CETIRIZINE"," CETIRIZINE ","30","Select","Select",""],["","","VITAMIN"," VITAMIN ","60","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","31","Select","Select",""],["","","HUMALOG"," HUMALOG ","20","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","40","Select","Select",""],["","49281042150","FLUZONE","INJ 2021-22","0","Select","Select",""],["","","NAPROXEN"," NAPROXEN ","60","Select","Select",""],["","","VOLTAREN"," VOLTAREN ","300","Select","Select",""],["","","LISINOPRIL"," LISINOPRIL ","30","Select","Select",""],["","","RELION"," RELION ","100","Select","Select",""],["","","DICLOFENAC"," DICLOFENAC ","300","Select","Select",""],["","","BENZONATATE"," BENZONATATE ","42","Select","Select",""],["","","VITRON-C","TAB 65-125","","Select","Select",""],["","","CALCARB","TAB \/VIT D","","Select","Select",""],["","","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","","HYDROCO\/APAP","TAB 10-325MG","","Select","Select",""],["","51672137706",""," ","29","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":{"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":""}]}]}