{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PATRICE   A JONES","gend":1,"add":"401 ROBERTS AVE APT 601","city":"PETERSBURG","state":"VA","zip":"23805-9998","dob":"1970-06-10","age":"","mstatus":"","insh":"20041722*01","cliId":"","pno":"804\/862-2967","cno":"","email":"","ename":"","eno":"","pphy":"JIN, XIAO HONG MD","ppno":"804\/732-0648","pcpadd":"15 GOODRICH AVE","pcpcity":"PETERSBURG","pcpstate":"VA","pcpzip":23805,"pcpcounty":"","pcpid":"","pcpname":"XIAO HONG JIN MD PLLC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/861-6846","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M50.00","M54.5","M54.2","R26.1","Z98.1","S39.012A","NO DATA","M79.672","E66.01","Z68.41","Z20.828","R05.","R68.83","Z00.01","K21.9","R13.10","K59.00","R11.11","M19.079","G95.9","B86.","R21.","B35.4","R53.1","F33.1","M54.16","T21.12XA","T21.02XA","F41.9","F32.9","I10.","Z00.00","F25.0","F39.","M62.830","S16.1XXA","G89.11","J20.9","J02.9","R26.0","S80.862A","S80.861A","W01.0XXA","Z47.89","M25.512","Z48.89","L03.012","L53.9","G95.89","G44.89","M25.361","M25.362","G82.50","L25.9","I49.3","M54.9","G44.219","R07.9","R51.9","F31.4","F43.10","G56.03","R10.30","F41.1","M47.12","R10.84","M62.838","S90.32XA","S09.90XA","Z71.2","R10.9"],"date":["2020-02-07","2021-09-09","2022-04-08","2021-11-11","2021-09-09","2021-11-11","2022-04-08","2022-01-25","2020-02-17","2020-02-17","2021-04-22","2021-04-22","2021-04-22","2021-10-22","2021-10-22","2021-10-22","2021-10-22","2021-10-22","2020-02-26","2021-06-21","2021-06-18","2022-04-18","2021-07-14","2021-03-04","2021-09-08","2020-05-11","2021-05-26","2021-05-26","2020-09-11","2020-09-11","2020-08-21","2021-06-04","2021-09-08","2021-09-08","2021-11-03","2022-01-25","2019-02-28","2019-04-15","2022-01-31","2019-04-15","2019-09-14","2019-09-14","2019-08-22","2019-06-27","2019-01-03","2019-01-03","2019-03-30","2019-03-30","2019-04-04","2022-02-10","2022-01-25","2022-01-25","2022-08-15","2022-03-14","2022-01-25","2022-05-02","2022-01-31","2022-03-05","2022-03-05","2022-08-24","2022-08-24","2022-01-25","2022-09-26","2022-09-26","2022-08-15","2022-09-23","2022-09-23","2022-01-25","2022-01-25","2022-05-02","2022-09-23"],"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":[["","52817033010","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","00536127803","LIDOCAINE","CRE 0.04","15","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","13","Select","Select",""],["","00713022515","TRIAMCINOLON","CRE 0.001","15","Select","Select",""],["","70700010915","CLOBETASOL","CRE 0.0005","15","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","11509020440","CEPACOL","LOZ 10-2.1MG","18","Select","Select",""],["","00536132701","ACETAMINOPHE","TAB 325MG","40","Select","Select",""],["","68462010805","TOPIRAMATE","TAB 25MG","180","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00067815202","VOLTAREN","GEL 0.01","50","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","180","Select","Select",""],["","52817032010","BACLOFEN","TAB 10MG","90","Select","Select",""],["","68382091634","METHYLPRED","TAB 4MG","21","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","30","Select","Select",""],["","","PREGABALIN","CAP 75MG","","Select","Select",""],["","00172572960","FAMOTIDINE","TAB 40MG","30","Select","Select",""],["","70710116201","MECLIZINE","TAB 25MG","60","Select","Select",""],["","00046087221","PREMARIN","CRE 0.625MG","30","Select","Select",""],["","23155050201","HYDROXYZ","TAB 50MG","90","Select","Select",""],["","21922002107","PERMETHRIN","CRE 0.05","60","Select","Select",""],["","29033020701","CARISOPRODOL","TAB 250MG","42","Select","Select",""],["","00378668877","PANTOPRAZOLE","TAB 20MG","30","Select","Select",""],["","68462031465","NYSTAT\/TRIAM","CRE ","60","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","15","Select","Select",""],["","00904671741","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","43598021055","SSD","CRE 0.01","50","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","45802004835","NYSTATIN","OIN 100000","30","Select","Select",""],["","42799080601","IVERMECTIN","TAB 3MG","4","Select","Select",""],["","00591544210","PREDNISONE","TAB 10MG","10","Select","Select",""],["","43547034050","RISPERIDONE","TAB 0.5MG","60","Select","Select",""],["","67618010110","COLACE","CAP 100MG","60","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","26","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","12","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","27241009903","DULOXETINE","CAP 60MG","60","Select","Select",""],["","","DIAZEPAM","TAB 5MG","","Select","Select",""],["","00591367001","NABUMETONE","TAB 500MG","60","Select","Select",""],["","00406052201","OXYCOD\/APAP","TAB 7.5-325","5","Select","Select",""],["","00168001431","HYDROCORT","CRE 0.005","28","Select","Select",""],["","65162010250","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","00781577626","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","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":""}]}]}