{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA   D PORTER","gend":1,"add":"4237 FARMHILL LN","city":"CHESTERFIELD","state":"VA","zip":"23832-9998","dob":"1952-05-08","age":"","mstatus":"","insh":"20052956*01","cliId":"","pno":"804\/244-0350","cno":"","email":"","ename":"","eno":"","pphy":"JORDAN-SAYLES, CHERYL J M D","ppno":"804\/226-2444","pcpadd":"4620 S LABURNUM AVE","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23231,"pcpcounty":"","pcpid":"","pcpname":"LABURNUM MEDICAL CENTER ","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/222-0458","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.9","F32.9","I10.","R07.89","E78.00","K21.9","Z51.81","E66.9","Z68.33","G47.33","Z68.36","F43.21","R13.10","K22.2","K29.70","K57.30","K64.1","Z83.71","Z12.11","Z12.31","L24.89","Z23.","M10.072","Z68.34","R19.7","R10.32","K57.90","J20.9","H90.41","F51.04","Z01.89","Z68.35","R05.","Z91.09","F51.02","R19.4","R10.814","H93.11","H90.5","S29.012A","F43.23","R73.02","Z63.79","N18.2","R79.89","NO DATA","M17.0","G89.29","I49.1","I49.3"],"date":["2022-10-11","2021-02-10","2022-10-11","2022-05-16","2022-10-11","2022-10-11","2022-10-11","2021-11-22","2022-10-11","2020-01-06","2021-04-02","2020-12-01","2021-10-15","2021-08-05","2021-08-05","2021-08-05","2021-08-05","2021-08-05","2020-02-05","2022-03-23","2022-10-11","2022-10-11","2020-02-10","2022-08-23","2021-10-15","2021-10-15","2021-08-05","2019-03-05","2019-11-04","2019-09-25","2019-09-17","2019-09-25","2019-04-05","2019-04-05","2019-04-05","2019-06-12","2019-06-12","2019-11-04","2019-11-04","2019-09-25","2022-06-16","2022-08-23","2022-03-23","2022-03-23","2022-03-23","2022-10-11","2022-08-23","2022-08-23","2022-05-16","2022-05-16"],"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":[["","00378363405","CARVEDILOL","TAB 25MG","60","Select","Select",""],["","","ALLOPURINOL","TAB 100MG","","Select","Select",""],["","00456141030","BYSTOLIC","TAB 10MG","30","Select","Select",""],["","00054429931","FUROSEMIDE","TAB 40MG","90","Select","Select",""],["","31722052001","HYDRALAZINE","TAB 25MG","270","Select","Select",""],["","68180051703","LISINOPRIL","TAB 40MG","30","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","67877039030","NEBIVOLOL","TAB 20MG","30","Select","Select",""],["","59762372004","ALPRAZOLAM","TAB 0.5MG","30","Select","Select",""],["","42806016005","HYDROXYZ","TAB 25MG","30","Select","Select",""],["","","INDOMETHACIN","CAP 25MG","","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","10572030201","PEG-3350\/KCL","SOL \/SODIUM","4000","Select","Select",""],["","52817018000","CLONIDINE","TAB 0.1MG","30","Select","Select",""],["","","TRIAMT\/HCTZ","TAB 75-50MG","","Select","Select",""],["","","PREDNISONE","TAB 10MG","","Select","Select",""],["","00168000215","TRIAMCINOLON","CRE 0.005","15","Select","Select",""],["","","FLUAD","INJ 0.5ML","","Select","Select",""],["","00603158658","PROMETHAZINE","SOL DM","180","Select","Select",""],["","43199001101","HYOSCYAMINE","SUB 0.125MG","30","Select","Select",""],["","68382056501","METOPROL","TAB 50MG ER","60","Select","Select",""],["","60258015001","SF","CRE 0.011","51","Select","Select",""],["","45802086803","POLYETH","POW 3350 NF","510","Select","Select",""],["","55111012701","CIPROFLOXACN","TAB 500MG","6","Select","Select",""],["","66685100100","AMOX\/K","TAB 875-125","28","Select","Select",""],["","00143993905","AMOXICILLIN","CAP 500MG","30","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":""}]}]}