{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GLORIA   M SANTANA","gend":1,"add":"1237 KESWICK LN","city":"RICHMOND","state":"VA","zip":"23225-9998","dob":"1953-11-30","age":"","mstatus":"","insh":"20034497*01","cliId":"","pno":"804\/332-9527","cno":"804\/663-8559","email":"","ename":"","eno":"","pphy":"MULLET, EMILY MD","ppno":"804\/230-7777","pcpadd":"4730 N SOUTHSIDE PLAZA","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23224,"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\/230-2371","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E21.3","NO DATA","C50.812","E11.65","I10.","R51.","F17.210","Z17.0","Z79.4","E11.319","H25.13","H40.003","C50.912","G89.18","R91.8","E11.9","Z85.528","Z48.3","I63.9","I69.351","E78.00","Z85.3","Z79.02","Z91.81","R94.31","M25.512","R63.4","M25.511","Z86.000","Z79.84","D05.12","Z08.","Z90.5","I51.7","I34.0","E83.52","R51.9","M79.601","R07.9","Z86.73","Z87.891","I77.810","Z51.11","C50.919","F17.200","M81.0","Z79.811","Z79.899","Z92.3","R19.7","Z90.12","I12.9","N18.3","M79.674","B35.1","R91.1","R93.0","I63.50","E78.5","E87.6","H54.7","Z79.82","Z88.8","Z90.49","Z92.21","Z51.12","C64.2","C50.112","Z90.13","Z23.","Z12.11","Z15.01","I87.8","U07.1","R06.02","K21.9","R50.81","R07.89","Z72.0","Z20.828","E11.22","N18.2","R11.0","R21.","M25.561","Z01.810","G43.909","Z00.00","E11.649","K62.89","K59.00","I08.8","M62.81","R25.9","V54.29","Z00.8","G89.29","N39.0","R53.1","R53.83","N20.0","N17.9","R62.7","Z20.822","M47.819","M54.9"],"date":["2019-04-16","2022-02-07","2020-11-19","2022-07-02","2022-07-02","2019-12-19","2022-01-16","2022-10-27","2022-07-02","2020-01-03","2020-01-03","2020-01-03","2022-10-27","2020-02-24","2022-10-27","2022-02-07","2022-11-08","2020-02-28","2021-09-27","2020-12-02","2020-12-02","2022-11-08","2022-01-16","2020-12-02","2021-10-27","2019-11-21","2019-10-16","2019-11-21","2019-11-21","2022-07-02","2021-04-22","2021-07-15","2022-11-08","2021-10-25","2021-01-28","2022-02-07","2022-10-27","2020-11-11","2020-11-11","2022-07-02","2020-11-11","2021-10-25","2021-03-04","2022-10-27","2022-10-27","2021-09-24","2021-07-15","2021-09-27","2021-04-22","2021-07-15","2021-07-15","2020-05-06","2019-01-28","2019-01-28","2019-01-28","2020-12-29","2020-04-02","2020-10-06","2022-07-02","2020-10-03","2020-10-03","2022-07-02","2020-10-03","2022-11-08","2020-10-03","2021-02-11","2022-02-07","2020-02-17","2020-10-14","2022-10-27","2021-09-24","2021-09-24","2021-10-25","2021-12-27","2021-12-27","2021-12-27","2021-12-27","2020-04-05","2022-05-15","2020-11-07","2020-05-06","2020-05-06","2020-05-06","2020-06-18","2020-06-18","2020-06-23","2020-09-29","2021-08-18","2021-09-27","2020-01-13","2020-01-22","2020-03-20","2020-10-02","2020-10-02","2022-02-07","2022-02-07","2022-02-07","2022-07-02","2022-07-02","2022-05-15","2022-01-16","2022-01-16","2022-01-16","2022-01-16","2022-11-08","2022-11-08"],"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":[["","","ANASTROZOLE","TAB 1MG","","Select","Select",""],["","","METFORMIN"," METFORMIN ","60","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX5\/32","100","Select","Select",""],["","","METOPROL"," METOPROL ","30","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","30","Select","Select",""],["","","AMLODIPINE"," AMLODIPINE ","30","Select","Select",""],["","","INSULIN"," INSULIN ","100","Select","Select",""],["","","LANTUS"," LANTUS ","3","Select","Select",""],["","00193731221","CONTOUR","TES NEXT","100","Select","Select",""],["","00002821501","HUMULIN","INJ U-100","10","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","","ASPIRIN","TAB 81MG EC","","Select","Select",""],["","","CLOPIDOGREL","TAB 75MG","","Select","Select",""],["","43547028910","BUPROPION","TAB 150MG SR","60","Select","Select",""],["","00363042816","NICOTINE","GUM 2MG MINT","160","Select","Select",""],["","00135046602","NICORETTE","GUM 2MG CINN","100","Select","Select",""],["","","DIAZEPAM","TAB 5MG","","Select","Select",""],["","00002751001","HUMALOG","INJ 100\/ML","10","Select","Select",""],["","","TRAMADOL","TAB 50MG","","Select","Select",""],["","","OXYCODONE","TAB 5MG","","Select","Select",""],["","","PROCHLORPER","TAB 10MG","","Select","Select",""],["","","LIDO\/PRILOCN","CRE 2.5-2.5%","","Select","Select",""],["","","PANTOPRAZOLE","TAB 20MG","","Select","Select",""],["","","VOLTAREN","GEL 0.01","","Select","Select",""],["","","ONDANSETRON","TAB 8MG","","Select","Select",""],["","","DIPHEN\/ATROP","TAB 2.5MG","","Select","Select",""],["","","TRIAMCINOLON","CRE 0.00025","","Select","Select",""],["","","DICLOFENAC","GEL 0.01","","Select","Select",""],["","","IBUPROFEN","TAB 400MG","","Select","Select",""],["","","ACETAMINOPHE","TAB 325MG","","Select","Select",""],["","","FISH","CAP 1000MG","","Select","Select",""],["","","CIPROFLOXACN","TAB 500MG","","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":""}]}]}