{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BERTHA   M KING","gend":1,"add":"4255 ANNE TERRACE APT 103","city":"PRINCE GEORGE","state":"VA","zip":"23875-9998","dob":"1967-08-07","age":"","mstatus":"","insh":"20030632*01","cliId":"","pno":"804\/255-5866","cno":"804\/490-2815","email":"","ename":"","eno":"","pphy":"GEORGE, LEELAMMA MD","ppno":"804\/526-8640","pcpadd":"215 TEMPLE AVE","pcpcity":"COLONIAL HEIGHTS","pcpstate":"VA","pcpzip":23834,"pcpcounty":"","pcpid":"","pcpname":"LEELAMMA GEORGE MD","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/526-4321","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H65.33","M25.572","M25.561","K52.89","N39.0","K50.914","D63.8","E44.0","N17.9","K51.514","D50.9","R63.0","R94.4","D72.829","H65.32","K50.913","N82.2","F32.9","F17.200","Z71.6","Z79.899","F43.0","K50.918","H91.92","R10.84","K50.90","Z12.11","K51.90","NO DATA","K63.1","A41.9","Z87.891","R19.7","E43.","Z01.812","Z20.822","R00.0","K50.112","K50.119","K62.6","H66.002","H72.91","K50.10","K50.114","D84.9","E87.6","K50.113","Z68.1","Z90.49","R10.9","Z68.20","M72.2","M20.11","M20.12","M77.9","H90.6","H65.01","H66.3X2","J31.0","J34.89","N82.3","M54.9","L98.8","H72.93","H65.499","K50.019","K50.012","M25.551","M54.2","R51.9","V89.2XXA","G89.29","R61.","K50.819","M70.031","R10.12","R10.32","R63.4","R63.8","R10.817","L03.818","E46.","K50.80","D64.9","N73.6","Z79.620","R31.29","Z04.9","Z20.828","R09.81","R11.0","R93.3"],"date":["2020-05-15","2021-05-10","2021-05-10","2021-07-09","2022-08-02","2021-11-07","2022-08-30","2021-11-07","2021-11-10","2021-11-30","2022-09-23","2021-11-30","2021-11-30","2022-10-13","2020-03-10","2020-08-10","2020-08-10","2020-08-10","2020-08-10","2020-08-10","2022-05-31","2020-10-24","2021-11-09","2020-03-10","2022-08-27","2022-10-11","2021-09-10","2021-09-10","2022-10-13","2021-11-03","2021-11-03","2022-10-11","2022-08-02","2021-11-10","2021-09-07","2022-10-11","2021-11-03","2022-10-12","2022-05-20","2021-09-10","2020-12-17","2020-12-17","2022-10-03","2021-11-10","2021-11-05","2022-08-30","2022-09-23","2021-11-05","2021-11-05","2022-10-12","2021-11-10","2019-01-19","2019-01-19","2019-01-19","2019-01-19","2019-12-06","2019-06-25","2019-08-22","2019-03-28","2019-03-28","2019-10-29","2022-06-16","2019-10-29","2019-11-06","2019-04-09","2019-02-13","2022-10-13","2022-06-16","2022-06-16","2022-06-16","2022-07-14","2022-09-16","2022-09-23","2022-04-06","2022-06-05","2022-08-02","2022-08-02","2022-05-31","2022-05-20","2022-02-05","2022-03-25","2022-05-31","2022-10-12","2022-10-13","2022-10-11","2022-10-11","2022-08-27","2022-07-01","2022-01-08","2022-01-08","2022-07-01","2022-10-12"],"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":[["","31722099601","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","13107005999","APAP\/CODEINE","TAB 300-30MG","15","Select","Select",""],["","69238110005","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","00591079501","DICYCLOMINE","TAB 20MG","15","Select","Select",""],["","67877075360","DRONABINOL","CAP 2.5MG","30","Select","Select",""],["","50383085924","MEGESTROL","SUS 40MG\/ML","440","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","16","Select","Select",""],["","","HUMIRA"," HUMIRA ","2","Select","Select",""],["","","PREDNISONE","TAB 20MG","","Select","Select",""],["","","MIRTAZAPINE"," MIRTAZAPINE ","30","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","51991018142","FERROCITE","TAB 324MG","90","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","12","Select","Select",""],["","16571066401","METRONIDAZOL","TAB 500MG","39","Select","Select",""],["","52817031910","BACLOFEN","TAB 5MG","30","Select","Select",""],["","65162046510","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","13668001001","CITALOPRAM","TAB 20MG","30","Select","Select",""],["","","AMOX\/K"," AMOX\/K ","20","Select","Select",""],["","00781106101","ALPRAZOLAM","TAB 0.25MG","15","Select","Select",""],["","42799060501","LOPERAMIDE","CAP 2MG","20","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","70010010801","GABAPENTIN","CAP 100MG","30","Select","Select",""],["","59746021106","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","62135030901","CIPROFLOXACN","TAB 500MG","26","Select","Select",""],["","","VITAMIN","CAP 50000UNT","","Select","Select",""],["","00065853302","CIPRODEX","SUS 0.3-0.1%","8","Select","Select",""],["","","FERROUS","TAB 324MG","","Select","Select",""],["","","CIPRO\/DEXA","SUS 0.3-0.1%","","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","57237001830","DULOXETINE","CAP 30MG","30","Select","Select",""],["","64380076921","PEG-3350\/KCL","SOL \/SODIUM","4000","Select","Select",""],["","","RA","TAB 24 HOUR","","Select","Select",""],["","11822489780","CENTRAL-VITE","TAB WMNS MAT","30","Select","Select",""],["","","HYDROXYZ","TAB 25MG","","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":""}]}]}