{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ARLEEN JACKSON","gend":1,"add":"1501 N 21ST ST APT 417","city":"RICHMOND","state":"VA","zip":"23223-9998","dob":"1955-06-04","age":"","mstatus":"","insh":"20040713*01","cliId":"","pno":"804\/683-3027","cno":"804\/309-0215","email":"","ename":"","eno":"","pphy":"GREEN JR, HAROLD T MD","ppno":"804\/644-1665","pcpadd":"STE 308 1510 N 28TH ST","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23223,"pcpcounty":"","pcpid":"","pcpname":"PRIMARY HEALTHCARE ASSOCIATES","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/644-5285","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.11","K59.00","N39.490","F33.9","N17.9","S50.02XA","K52.9","F17.200","W19.XXXA","Y92.000","R10.84","F41.9","F32.9","I10.","H92.09","E78.00","E66.01","F41.8","J45.20","M62.838","R63.5","E55.9","Z68.39","M47.812","M50.30","R10.0","R11.2","R19.7","U07.1","J96.01","E78.5","F17.210","NO DATA","Z68.38","Z79.51","Z79.899","Z87.440","Z98.51","N30.00","M47.817","R10.9","M51.9","M51.36","Z02.89","M51.35","K21.9","L02.224","L84.","M21.612","Z68.41","R03.0","M54.9","M50.10","H66.90","K21.0","M47.899"],"date":["2020-01-23","2020-02-26","2021-12-01","2021-12-09","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2020-03-24","2021-12-01","2020-03-24","2021-12-01","2020-11-13","2021-12-01","2021-12-01","2020-11-13","2020-11-13","2020-11-13","2020-11-13","2020-11-13","2020-11-13","2020-01-22","2020-03-25","2020-09-30","2021-12-01","2020-09-30","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-02-16","2021-02-16","2021-12-01","2019-08-16","2019-05-01","2019-12-23","2019-06-14","2019-06-14","2019-01-30","2019-01-30","2019-01-30","2019-01-30","2019-09-20","2019-09-20","2019-06-05","2019-01-24","2019-06-05","2019-10-21"],"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":[["","","SUCRALFATE"," SUCRALFATE ","120","Select","Select",""],["","","TOPIRAMATE"," TOPIRAMATE ","36","Select","Select",""],["","","BUPROPION"," BUPROPION ","24","Select","Select",""],["","","LEVOFLOXACIN","TAB 500MG","","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","90","Select","Select",""],["","","AMMONIUM"," AMMONIUM ","226","Select","Select",""],["","","QUETIAPINE"," QUETIAPINE ","24","Select","Select",""],["","80681004001","MELATONIN","TAB 5MG","30","Select","Select",""],["","","OMEPRAZOLE"," OMEPRAZOLE ","30","Select","Select",""],["","","HYDROCHLOROT"," HYDROCHLOROT ","30","Select","Select",""],["","","LOSARTAN"," LOSARTAN ","30","Select","Select",""],["","49884037301","DEXAMETHASON","TAB 6MG","8","Select","Select",""],["","62559099212","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","57896079101","SIMETHICONE","CHW 80MG","30","Select","Select",""],["","42806054701","VITAMIN","CAP 1.25MG","7","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","43598044828","NICOTINE","DIS 21MG\/24H","28","Select","Select",""],["","80681000200","ZINC","TAB 50MG","7","Select","Select",""],["","49035019402","EQ","DIS 21MG\/24H","14","Select","Select",""],["","00904506860","MI-ACID","CHW 80MG","30","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","68645051554","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","","DULOXETINE","CAP 30MG","","Select","Select",""],["","","LIDOCAINE","PAD 0.05","","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","","MELOXICAM","TAB 7.5MG","","Select","Select",""],["","","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","","DICYCLOMINE","CAP 10MG","","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":""}]}]}