{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GARY ANDERSON","gend":0,"add":"900 CLEMENTOWN ROAD","city":"POWHATAN","state":"VA","zip":23139,"dob":"1969-04-19","age":"","mstatus":"","insh":"20057064*01","cliId":"","pno":"804\/467-2902","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"804\/285-6050","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23139,"pcpcounty":"","pcpid":"","pcpname":"POWHATAN MEDICAL ASSOCIATES","plan":"OHP","program":"Medicaid","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/598-2481","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["NO DATA","R10.9","E11.65","I16.0","E78.2","I10.","J45.909","N31.9","E66.9","Z66.","F11.10","E11.43","F17.210","F32.9","G89.29","M54.5","M19.90","Z79.4","J30.89","Z68.34","M25.9","K22.10","E86.0","R82.4","R11.2","R39.81","S90.422A","X58.XXXA","Y92.89","Y93.89","E87.2","R73.9","T40.2X1A","A41.9","J18.9","F14.921","E87.6","R94.31","R65.20","F14.10","E11.29","R80.9","N17.9","K22.11","I24.8","E11.3293","K76.0","Z20.822","V58.69","Z91.128","M47.816","K29.70","R32.","G89.4","K92.0","R10.13","F19.90","Z68.37","E11.9","E78.5","K21.9","E78.00","Z87.891","Z79.899","M79.89","Z11.59","Z68.33","R06.02","R77.8","Z91.19","R00.0","R10.84","R11.10","T78.1XXA","K31.84","D47.3","Z68.32","Z79.84","Z91.018","Z98.1","J16.8","R07.89","Z20.828","R07.9","Z09.","F54.","F11.90","E10.10","L03.116","L08.9","V58.89","R53.83","R33.9","Z68.36","Z91.14","E66.09","T30.0","H25.13","H47.20","H11.153","K21.0","Z68.35","R74.8","R11.0","N17.0","E08.9","E55.9","Z12.11","B35.1","L84.","Z12.5","R13.10","L03.213","E87.1","Z68.38","E11.649","Z82.49","Z82.61","Z83.3","R11.11","Z68.41","M47.896","Z86.2","R09.81"],"date":["2022-09-08","2020-12-18","2022-09-09","2021-09-01","2022-02-23","2022-09-07","2022-09-07","2022-10-22","2020-12-18","2020-12-18","2020-12-18","2022-09-07","2021-09-01","2020-12-18","2021-03-01","2020-12-18","2022-08-21","2022-09-09","2021-04-05","2021-04-05","2021-04-05","2021-09-02","2021-07-25","2021-07-25","2022-09-09","2022-10-22","2020-05-05","2020-05-05","2020-05-05","2020-05-05","2021-09-01","2021-03-04","2020-09-07","2021-03-04","2020-09-07","2020-09-07","2022-09-09","2022-06-19","2021-03-04","2021-09-02","2020-09-07","2020-09-07","2022-09-09","2021-03-01","2021-03-01","2021-03-01","2021-03-01","2021-09-01","2021-03-01","2021-03-01","2021-03-01","2021-03-01","2021-03-01","2021-09-02","2022-09-08","2022-09-09","2022-04-02","2021-09-02","2022-08-21","2022-08-21","2022-08-21","2022-08-21","2022-09-07","2022-09-07","2020-05-05","2022-02-23","2021-03-08","2022-06-18","2021-03-02","2021-03-02","2021-09-01","2022-09-04","2022-09-04","2021-12-06","2022-09-07","2020-01-10","2020-01-10","2020-01-10","2020-01-10","2022-09-07","2020-09-07","2020-09-07","2020-12-18","2020-12-18","2021-03-08","2020-09-08","2020-09-08","2021-03-02","2020-05-10","2020-05-10","2020-05-10","2021-09-01","2022-10-20","2021-10-05","2021-10-05","2020-12-18","2021-03-03","2019-05-20","2019-05-20","2019-05-20","2019-10-07","2019-10-07","2019-10-02","2019-10-02","2022-09-07","2022-09-07","2022-02-23","2022-02-23","2022-02-23","2022-02-23","2022-02-23","2022-04-12","2022-08-21","2022-09-09","2022-09-09","2022-09-07","2022-09-07","2022-09-07","2022-09-07","2022-03-31","2022-06-19","2022-08-21","2022-08-21","2022-08-21"],"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":{"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":[["","00088221905","LANTUS","INJ 100\/ML","3","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","180","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","20","Select","Select",""],["","00955172901","INSULIN","SOL 100U\/ML","10","Select","Select",""],["","","ONETOUCH","KIT ULTRA 2","","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","08290320119","BD  PEN NEEDL","MIS 31GX5MM","50","Select","Select",""],["","76385012810","METFORMIN","TAB 500MG ER","60","Select","Select",""],["","58160084252","BOOSTRIX","INJ ","0","Select","Select",""],["","00002143380","TRULICITY","INJ 0.75\/0.5","2","Select","Select",""],["","00093220305","METOCLOPRAM","TAB 10MG","12","Select","Select",""],["","65162006205","SUCRALFATE","SUS 1GM\/10ML","200","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","20","Select","Select",""],["","","KLOR-CON","TAB 10MEQ ER","","Select","Select",""],["","59746011306","PROCHLORPER","TAB 5MG","20","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","6","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","24208031510","POLYMYXIN","SOL TRIMETHP","10","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","10","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","68","Select","Select",""],["","76385012350","METHOCARBAM","TAB 500MG","20","Select","Select",""],["","69842093108","ACETAMINOPHN","TAB 500MG","24","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","30","Select","Select",""],["","59779050301","OMEPRAZOLE","TAB 20MG","30","Select","Select",""],["","59779045806","CVS","TAB 10MG","90","Select","Select",""],["","59779045888","ALLERGY","TAB 10MG","90","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","08626412301","BLOOD","KIT SYSTEM","1","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","","CLINDAMYCIN","CAP 150MG","","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","","DOXYCYCL","TAB 100MG","","Select","Select",""],["","","DOXYCYC","TAB 100MG","","Select","Select",""],["","64980027903","GLIPIZIDE","TAB 2.5MG","10","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}