{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LEYNA   C DENTON","gend":1,"add":"7711 ALVARADO ROAD","city":"HENRICO","state":"VA","zip":"23229-9998","dob":"1985-08-26","age":"","mstatus":"","insh":"20056938*01","cliId":"","pno":"804\/519-7844","cno":"804\/519-7844","email":"","ename":"","eno":"","pphy":"FOUNTAIN-ELLIS, TAMI MD","ppno":"804\/741-6200","pcpadd":"9600 PATTERSON AVENUE","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23229,"pcpcounty":"","pcpid":"","pcpname":"PATTERSON AVENUE FAMILY PRACTICE","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/741-6213","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z01.419","Z11.3","M96.0","M79.605","F41.0","F32.9","G62.9","G89.29","Z51.81","E03.9","Z68.42","Z20.828","L70.9","F52.0","H40.013","H04.123","F43.12","R06.83","R53.83","G47.00","G25.81","NO DATA","N81.9","N32.81","N30.10","N39.3","M25.372","Z23.","M76.62","M77.52","M76.72","M76.822","M96.89","M21.372","F41.9","F43.10","R41.840","R41.3","F84.0","M54.41","M47.814","G57.92","Z79.899","F41.8","R11.0","D72.829","J31.0","J34.89","M26.609","R43.9","J34.2","G57.01","Z68.43","Z91.89","E66.01","R10.9","F32.1","F90.0","F45.0","N36.42","Z01.818","N39.46","J45.990","E78.00","K21.9","Z86.2","H40.003","R35.0"],"date":["2022-04-20","2022-04-20","2020-04-03","2021-09-16","2020-07-30","2021-08-12","2020-12-03","2021-09-16","2021-09-16","2022-10-25","2021-12-13","2021-08-22","2022-04-20","2022-04-20","2022-07-13","2022-07-13","2020-01-21","2020-09-29","2020-09-29","2020-09-29","2020-09-29","2021-12-13","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2020-06-01","2021-12-16","2020-03-16","2020-03-16","2021-05-03","2020-10-12","2020-10-12","2021-05-03","2022-05-24","2022-05-24","2021-08-12","2021-08-12","2022-05-24","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2022-09-30","2022-09-30","2022-09-30","2022-09-30","2022-09-30","2020-12-03","2022-10-25","2021-04-29","2022-10-25","2021-04-29","2022-05-24","2022-05-24","2022-05-24","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2020-11-24","2020-05-21"],"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":[]},{"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":[["","43598024730","FESOTERODINE","TAB 4MG ER","90","Select","Select",""],["","27241019230","TOLTERODINE","CAP 4MG ER","30","Select","Select",""],["","00555902542","JUNEL","TAB ","84","Select","Select",""],["","51991074810","DULOXETINE","CAP 60MG","90","Select","Select",""],["","69097081307","GABAPENTIN","CAP 100MG","60","Select","Select",""],["","45802016000","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00069024230","TOVIAZ","TAB 4MG","30","Select","Select",""],["","69238183007","LEVOTHYROXIN","TAB 25MCG","30","Select","Select",""],["","80064014104","VYLEESI","INJ 1.75\/0.3","1","Select","Select",""],["","00093681673","BUDESONIDE","SUS 0.5MG\/2","60","Select","Select",""],["","73336007590","GEMTESA","TAB 75MG","31","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","50","Select","Select",""],["","69238111501","BUSPIRONE","TAB 5MG","30","Select","Select",""],["","65162019010","NAPROXEN","TAB 500MG","60","Select","Select",""],["","59746000106","METHYLPRED","TAB 4MG","18","Select","Select",""],["","69097084607","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","45802088014","NYSTAT\/TRIAM","CRE ","30","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","100","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","20","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","20","Select","Select",""],["","41167005840","ASPERCREME","PAD LIDO 4%","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":""}]}]}