{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"REGINA   B PEREZ","gend":1,"add":"706 W RIVER DR APT A","city":"HENRICO","state":"VA","zip":"23229-9998","dob":"1965-08-17","age":"","mstatus":"","insh":"20033307*01","cliId":"","pno":"804\/277-1016","cno":"","email":"","ename":"","eno":"","pphy":"MASTERSON, AIVI N 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":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/741-6213","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.4","F41.1","R00.0","L08.9","E66.01","Z68.43","I10.","A41.9","F31.81","M54.16","M51.26","N39.0","N17.9","N20.1","N13.2","R78.81","N15.1","M79.662","M79.661","R06.83","R06.89","R06.81","I48.91","F31.9","K21.9","Z12.4","R32.","R60.0","I50.33","I48.0","N39.46","E78.2","N20.0","J45.20","Z76.89","Z68.42","L02.214","L03.314","B37.2","E78.5","R73.9","M17.0","I48.92","K27.9","R51.","I13.0","I50.31","N18.2","G47.33","I67.1","E78.00","Z86.73","Z86.79","Z12.39","M17.11","R13.10","Z20.828","Z79.01","Z87.11","Z87.442","F90.9","M19.90","R11.2","NO DATA","M54.5","R51.9","R11.10","I51.7","T19.1XXA","M79.604","Z68.39","L91.8","Z09.","F33.1","R55.","I63.9","R29.818","Z01.810","I49.1","I21.19","R94.31","N20.2","R10.9","D64.9","Z48.89","M70.61","I50.9","R26.9","Z98.890","F41.9","J20.8","Z46.6","R31.9","R82.998","B37.9","M54.31","R50.9","Z20.822","R82.90","T83.84XA","Z79.899","R65.10","Z91.81","M54.41","G89.29","R39.81","E66.9","Z98.891","Z13.220","Z12.11","B96.4","N13.6","R65.21","F32.9","L30.4","R60.9","F43.10","F33.9","J06.9","E66.2","I69.30","S82.401S","S82.402A","G47.30","V54.16","I69.351","R29.6","I95.2","S82.62XA","F43.22","R20.2","D72.829","F43.9","G47.00","Z23.","S82.401A","W19.XXXA","Z74.09","M62.838","R42.","I95.9","R06.00","I63.512","S82.464A","F31.70","M25.571","M79.671","M54.17","R21.","R53.81","M17.12","R07.9","F43.20","R09.81","Z00.00","J01.90","S82.452A","S82.64XA","W18.30XA","Y92.89","Y93.89","R22.2","R10.11","R30.0","M54.6","M25.569","Z98.61","R07.2","I25.110","G45.9","Z12.31","M47.817","I11.0","E87.5","M79.674","B35.1","D62.","R73.03"],"date":["2020-09-06","2020-09-06","2020-05-08","2020-05-12","2022-07-01","2022-10-06","2022-10-19","2021-03-12","2022-10-12","2020-10-16","2020-10-16","2021-03-12","2022-10-08","2021-03-12","2021-06-10","2021-03-12","2021-03-12","2021-03-18","2021-03-18","2021-04-19","2021-04-19","2021-04-19","2022-09-28","2021-06-17","2022-10-19","2021-06-17","2021-06-17","2021-06-17","2022-03-22","2022-10-06","2021-09-08","2022-07-01","2021-09-08","2021-09-20","2021-09-08","2022-01-25","2020-06-10","2020-06-10","2020-08-12","2020-06-10","2021-01-22","2021-03-11","2020-06-10","2020-06-10","2020-06-10","2021-03-31","2022-09-14","2021-03-31","2022-05-30","2021-03-31","2022-10-03","2021-03-31","2022-10-03","2020-02-24","2022-04-04","2020-02-24","2020-05-08","2022-09-28","2020-05-23","2021-07-27","2020-05-08","2021-03-11","2020-05-27","2022-10-24","2020-10-28","2020-11-13","2020-11-13","2022-10-03","2021-07-27","2021-09-29","2020-05-07","2020-06-26","2020-08-12","2020-11-18","2021-03-18","2021-03-18","2021-05-27","2021-07-23","2021-07-23","2021-07-23","2021-07-23","2021-08-21","2021-08-21","2022-10-19","2020-08-12","2020-09-15","2021-06-17","2021-03-31","2022-10-03","2022-09-14","2021-06-24","2021-07-27","2021-07-01","2021-07-01","2021-04-26","2022-09-07","2021-03-10","2021-03-11","2021-06-10","2021-06-10","2021-06-10","2020-05-08","2020-06-01","2020-10-28","2020-10-28","2020-04-24","2020-05-23","2020-05-23","2021-01-22","2022-10-19","2021-03-11","2021-03-11","2021-03-11","2021-03-11","2021-03-11","2021-03-18","2019-07-07","2019-10-27","2019-10-06","2019-11-05","2019-11-05","2019-11-05","2019-11-03","2019-11-12","2019-11-12","2019-11-12","2019-11-12","2019-11-15","2019-10-19","2019-10-19","2019-10-21","2019-10-19","2019-10-19","2019-10-19","2022-10-19","2019-10-22","2019-10-22","2019-10-25","2019-10-25","2019-10-25","2019-10-29","2019-10-25","2019-11-06","2019-11-06","2019-11-06","2019-11-14","2019-11-14","2019-06-12","2019-06-12","2019-11-02","2019-01-23","2022-10-08","2019-10-23","2019-11-04","2019-01-15","2019-10-06","2019-10-19","2019-10-19","2019-10-19","2019-10-19","2019-10-19","2019-03-20","2019-03-20","2019-10-18","2019-10-18","2022-01-25","2022-05-31","2022-10-06","2022-10-03","2022-10-03","2022-04-29","2022-09-07","2022-09-14","2022-10-05","2022-10-24","2022-10-24","2022-10-08","2022-10-19"],"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":[["","","ALBUTEROL","AER HFA","","Select","Select",""],["","65862047090","LOSARTAN\/HCT","TAB 100-25","30","Select","Select",""],["","31722088290","ROSUVASTATIN","TAB 5MG","30","Select","Select",""],["","65862049001","QUETIAPINE","TAB 50MG","30","Select","Select",""],["","65862056090","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","62332002991","LOSARTAN","TAB 100MG","30","Select","Select",""],["","65862066330","ARIPIPRAZOLE","TAB 10MG","30","Select","Select",""],["","00378021610","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","00363033601","ACETAMINOPHE","TAB 650MG ER","30","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","","LAMOTRIGINE","TAB 150MG","","Select","Select",""],["","69842087651","CVS","TAB 325MG","12","Select","Select",""],["","00597036055","PRADAXA","CAP 150MG","60","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","68682000610","DILTIAZEM","TAB 30MG","90","Select","Select",""],["","00054001125","FLECAINIDE","TAB 100MG","60","Select","Select",""],["","31722062260","DABIGATRAN","CAP 150MG","60","Select","Select",""],["","69238207707","PROPRANOLOL","TAB 10MG","30","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","8","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","55111072901","ALLOPURINOL","TAB 100MG","90","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","00603497528","OXYBUTYNIN","TAB 5MG","60","Select","Select",""],["","00527133701","BACLOFEN","TAB 20MG","30","Select","Select",""],["","46122006271","8","TAB 650MG","30","Select","Select",""],["","65862053820","LEVOFLOXACIN","TAB 750MG","10","Select","Select",""],["","00093321915","KETOCONAZOLE","CRE 0.02","15","Select","Select",""],["","00093506201","HYDROXYZ","TAB 50MG","90","Select","Select",""],["","50111043302","TRAZODONE","TAB 50MG","60","Select","Select",""],["","29300013510","CLONIDINE","TAB 0.1MG","30","Select","Select",""],["","68180030360","CEFUROXIME","TAB 500MG","14","Select","Select",""],["","","OXYCODONE","TAB 5MG","","Select","Select",""],["","","GABAPENTIN","CAP 300MG","","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","8","Select","Select",""],["","00536113428","MICONAZOLE","CRE 0.02","30","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","57237001401","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","","NYSTATIN","CRE 100000","","Select","Select",""],["","75826011510","PHENAZOPYRID","TAB 200MG","9","Select","Select",""],["","63736012002","NIX","LIQ 0.01","59","Select","Select",""],["","67877057505","BENZONATATE","CAP 200MG","20","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","69238110305","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","33342007610","VALSART\/HCTZ","TAB 160-25MG","30","Select","Select",""],["","13107003134","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","00591367001","NABUMETONE","TAB 500MG","60","Select","Select",""],["","69097084805","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","","VENTOLIN","AER ","","Select","Select",""],["","","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","","FLUZONE","INJ 2020-21","","Select","Select",""],["","","BUT\/APAP\/CAF","TAB ","","Select","Select",""],["","","APAP\/CODEINE","TAB 300-30MG","","Select","Select",""],["","00713022515","TRIAMCINOLON","CRE 0.001","15","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","65862044990","VALACYCLOVIR","TAB 1GM","21","Select","Select",""],["","00904672360","DOK","TAB 50-8.6MG","60","Select","Select",""],["","00363078522","SENNA-S","TAB 8.6-50MG","60","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","59148000813","ABILIFY","TAB 10MG","30","Select","Select",""],["","69336083530","LIDOTREX","GEL 0.02","28","Select","Select",""],["","15455956601","KAMDOY","EMU ","60","Select","Select",""],["","00008084181","PROTONIX","TAB 40MG","30","Select","Select",""],["","00456201001","LEXAPRO","TAB 10MG","30","Select","Select",""],["","00310075590","CRESTOR","TAB 5MG","30","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":""}]}]}