{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DANIEL GREEN","gend":0,"add":"1507 HELEN LN","city":"RICHMOND","state":"VA","zip":"23224-9998","dob":"1965-12-09","age":"","mstatus":"","insh":"20051470*01","cliId":"","pno":"804\/386-6377","cno":"804\/386-6377","email":"","ename":"","eno":"","pphy":"LANDES, LORI H MD","ppno":"804\/230-7777","pcpadd":"4730 N SOUTHSIDE PLAZA","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23224,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/628-3919","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","G47.33","I10.","I48.91","Z87.891","NO DATA","M51.26","M54.5","Z51.81","F14.10","M54.16","I48.92","R73.03","Z79.01","I49.9","I63.9","F11.129","Z72.89","F11.90","F14.20","F19.10","F19.90","M25.512","G89.29","F33.3","R31.0","R21.","R09.02","G47.10","G47.00","Z79.899","M54.17","M47.817","G89.4","Z59.0","F11.10","Z01.812","Z11.59","I48.0","Z86.79","R07.9","R00.0","Z23.","R94.5","N17.9","E78.2","H54.7","R61.","M54.6","R91.8","D64.9","E78.5","N52.9","R51.9","Y04.0XXA","F14.90","M25.552","F15.20","F33.2","F43.10","F41.1","G62.9","W01.0XXA","F11.99","I51.7","I35.1","Z20.822","G47.30","S46.002A","M16.12","M25.562","R44.3","R31.9","E66.09","Z68.27","R09.89","R05.9","B97.4","Z11.52","R74.8","F10.10","V58.89","Z01.810","R06.02","R63.5","R06.2","R00.1","M18.11","M65.9","I28.9","E83.42"],"date":["2022-10-24","2021-08-16","2022-09-06","2021-10-07","2022-09-06","2022-05-16","2020-05-21","2021-03-17","2020-02-21","2022-08-31","2022-05-16","2021-10-07","2021-10-07","2022-05-16","2021-10-07","2022-02-11","2022-02-11","2022-02-11","2022-05-16","2022-02-16","2022-09-06","2022-08-31","2022-05-16","2022-09-06","2022-10-24","2020-08-03","2020-02-24","2020-02-28","2021-06-11","2020-02-28","2022-02-25","2020-05-21","2021-12-29","2022-05-16","2020-04-13","2020-06-11","2021-01-15","2021-01-15","2022-10-06","2021-12-29","2021-12-29","2021-12-29","2022-09-06","2022-09-06","2022-09-06","2022-09-06","2022-09-06","2022-09-06","2022-09-06","2020-08-03","2020-08-03","2021-11-30","2020-08-03","2021-07-03","2021-07-03","2022-02-25","2020-01-15","2020-03-16","2020-01-23","2020-03-16","2020-03-16","2020-08-03","2020-08-03","2020-01-07","2021-01-13","2021-01-13","2021-04-21","2021-06-11","2021-07-30","2021-07-30","2021-07-30","2022-10-24","2020-04-27","2021-07-30","2021-07-30","2021-11-30","2021-11-30","2021-11-30","2021-11-30","2022-09-06","2022-03-01","2022-09-06","2020-09-22","2020-09-22","2020-09-22","2020-09-22","2020-10-12","2022-08-09","2022-08-09","2021-01-28","2021-01-28"],"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":[["","67877019705","AMLODIPINE","TAB 2.5MG","90","Select","Select",""],["","55111017915","TIZANIDINE","TAB 2MG","60","Select","Select",""],["","69547035302","NARCAN","SPR 4MG","2","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","28","Select","Select",""],["","00378876793","BUPREN\/NALOX","MIS 8-2MG","28","Select","Select",""],["","00527260243","METOPROL","TAB 100MG ER","30","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","57896026801","ACETAMINOPHE","TAB 650MG ER","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","00378395205","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","13107003134","MIRTAZAPINE","TAB 15MG","90","Select","Select",""],["","60505267603","ARIPIPRAZOLE","TAB 20MG","30","Select","Select",""],["","69452013317","DOFETILIDE","CAP 500MCG","120","Select","Select",""],["","65162006205","SUCRALFATE","SUS 1GM\/10ML","1200","Select","Select",""],["","64764011907","COLCRYS","TAB 0.6MG","6","Select","Select",""],["","00378108601","COLCHICINE","TAB 0.6MG","6","Select","Select",""],["","65162010150","GABAPENTIN","CAP 100MG","240","Select","Select",""],["","65862078330","ESOMEPRA","CAP 20MG DR","90","Select","Select",""],["","43598043611","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00363010412","PAIN","TAB 325MG","120","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","15","Select","Select",""],["","10631001030","KAPSPARGO","CAP 100MG","30","Select","Select",""],["","57237004105","PENICILLN","TAB 500MG","30","Select","Select",""],["","00093762598","PREGABALIN","CAP 100MG","60","Select","Select",""],["","00406117003","NALTREXONE","TAB 50MG","90","Select","Select",""],["","50580072636","ZYRTEC","TAB 10MG","90","Select","Select",""],["","00378165993","SILDENAFIL","TAB 50MG","9","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","90","Select","Select",""],["","00067815202","VOLTAREN","GEL 0.01","100","Select","Select",""],["","10572010001","PEG-3350","SOL ELECTROL","4000","Select","Select",""],["","00904674880","BISACODYL","TAB 5MG EC","4","Select","Select",""],["","00378020810","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","00168001531","HYDROCORT","CRE 0.01","28","Select","Select",""],["","65862073205","AMIODARONE","TAB 200MG","60","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":""}]}]}