{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JUSTIN   M CARSON","gend":0,"add":"20640 EMERALD POINT TERRACE","city":"STERLING","state":"VA","zip":"20165-9998","dob":"1987-10-21","age":"","mstatus":"","insh":"20050584*01","cliId":"","pno":"703\/433-2574","cno":"703\/433-2574","email":"","ename":"","eno":"","pphy":"MARTIN, JEFFREY MD","ppno":"703\/450-1124","pcpadd":"SUITE 107 46440 BENEDICT DRIVE","pcpcity":"STERLING","pcpstate":"VA","pcpzip":20164,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"703\/450-1145","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.41","F10.220","M54.16","G89.29","M51.26","M51.36","M79.673","V58.89","S33.5XXA","S39.012A","Z98.890","S66.912A","M47.816","M54.5","M96.1","Z00.00","F51.04","I10.","E78.00","E55.9","F41.9","M54.42","NO DATA","Z01.818","G89.18","Z79.891","Z51.81","F32.9","M51.16","Z87.891","M79.605","G89.4","L25.5","L03.116","L25.9","M54.9","R21.","S39.92XA","M47.9","R11.2","R09.81","Z87.19","Z11.59","M51.27","Z02.9","S06.0X0A","M54.32","M54.2","G44.309","R42.","S06.0X9A","R52.","M54.89","H60.92","F17.210","R20.0","T78.40XA","S16.1XXA","M79.645","S66.812A","M48.02","M79.604","J31.0","J32.9","M51.17","M48.07"],"date":["2020-12-08","2020-03-09","2022-11-07","2022-11-07","2021-01-07","2021-01-07","2020-06-19","2021-08-12","2021-04-26","2021-04-26","2022-05-06","2021-05-21","2022-11-07","2021-08-19","2022-11-07","2022-03-10","2022-03-10","2022-04-01","2022-03-10","2022-03-10","2022-03-10","2022-05-06","2022-11-07","2020-05-27","2020-08-24","2022-11-07","2021-04-22","2021-02-21","2022-02-23","2021-04-21","2021-04-21","2022-01-14","2020-06-29","2020-06-30","2020-06-30","2021-02-18","2020-06-30","2020-12-05","2020-09-14","2021-11-30","2021-11-30","2021-11-30","2021-11-30","2022-04-21","2022-04-21","2021-03-04","2021-08-01","2021-08-12","2021-08-12","2021-08-12","2021-08-12","2020-03-09","2020-03-09","2020-06-11","2020-11-16","2020-11-16","2021-02-18","2021-02-26","2021-04-19","2021-04-19","2020-05-27","2020-10-30","2021-04-10","2021-04-10","2022-03-11","2022-03-11"],"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":[]},{"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":[["","13811070210","HYDROMORPHON","TAB 12MG ER","30","Select","Select",""],["","51991070505","ALPRAZOLAM","TAB 0.5MG","60","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","10702005601","OXYCODONE","TAB 10MG","90","Select","Select",""],["","59385002260","BELBUCA","MIS 150MCG","60","Select","Select",""],["","00172392770","DIAZEPAM","TAB 10MG","30","Select","Select",""],["","59746036290","VALSARTAN","TAB 160MG","30","Select","Select",""],["","00378911998","FENTANYL","DIS 12MCG\/HR","10","Select","Select",""],["","00781717612","NALOXONE","SPR ","2","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","00603459315","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00228212750","CLONIDINE","TAB 0.1MG","60","Select","Select",""],["","53191036201","D3-50","CAP 50000UNT","13","Select","Select",""],["","71093014105","METHOCARBAM","TAB 750MG","15","Select","Select",""],["","00378110101","PRAZOSIN","CAP 1MG","90","Select","Select",""],["","59011041010","OXYCONTIN","TAB 10MG CR","20","Select","Select",""],["","65862050220","AMOX\/K","TAB 500-125","6","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","60","Select","Select",""],["","60842005101","EVZIO","INJ 2\/0.4ML","2","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","16571041250","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","27","Select","Select",""],["","53191036201","VITAMIN","CAP 50000UNT","13","Select","Select",""],["","00135061502","FLONASE","SUS 27.5MCG","6","Select","Select",""],["","51991074690","DULOXETINE","CAP 20MG","30","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","00093365740","BUPRENORPHIN","DIS 10MCG\/HR","4","Select","Select",""],["","59011075004","BUTRANS","DIS 5MCG\/HR","4","Select","Select",""],["","00225038080","AYR","SPR 0.0065","50","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","21","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","42858080101","MORPHINE","TAB 15MG ER","30","Select","Select",""],["","13668033001","TRAZODONE","TAB 50MG","90","Select","Select",""],["","72205001390","PREGABALIN","CAP 75MG","60","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","71858030505","LICART","DIS 0.013","30","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","6","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","33342025866","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","50428246105","CVS","GUM 4MG ORIG","100","Select","Select",""],["","69097081312","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","53746019401","NAPROXEN","TAB 550MG","12","Select","Select",""],["","24510011510","XTAMPZA","CAP 13.5MG","60","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","68180030360","CEFUROXIME","TAB 500MG","20","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","24208063562","NEO\/POLY\/HC","SUS 1% OTIC","10","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","30","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","40","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":""}]}]}