{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WILLIAM   M HUBBARD","gend":0,"add":"400 S PINE ST","city":"RICHMOND","state":"VA","zip":"23220-9998","dob":"1965-08-18","age":"","mstatus":"","insh":"20061570*01","cliId":"","pno":"804\/593-6015","cno":"","email":"","ename":"","eno":"","pphy":"JACKSON, RICHARD A MD","ppno":"804\/225-7148","pcpadd":"304 E LEIGH ST","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23219,"pcpcounty":"","pcpid":"","pcpname":"Dominion Medical Associates, INC.","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/225-7159","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","F33.0","F90.2","I49.9","I51.7","F31.81","F43.21","I21.02","I10.","Z87.19","I95.9","F17.210","Z95.5","N17.9","T81.9XXA","I25.10","R10.84","R10.13","F41.1","F33.9","R03.0","F33.3","R80.9","R07.9","K21.9","I25.2","F39.","F12.90","I51.89","Z98.890","R00.1","F33.2","K29.90","R10.9","R00.0","F12.20","F31.9","G47.00","F32.9","F17.200","Z59.0","R42.","R11.10","NO DATA","H44.20","H31.093","H25.13","H25.012","R11.2","E44.0","Z68.1","Z20.822","Z86.19","I21.4","R94.31","B17.9","K85.90","K72.00","F12.10","E78.1","Z82.0","Z79.899","B19.10","S00.81XA","I46.9","I49.01","K29.70","Z99.11","W13.8XXA","W19.XXXA"],"date":["2022-05-13","2021-11-03","2021-05-09","2021-06-01","2021-12-19","2022-07-26","2021-12-27","2021-06-02","2021-05-30","2021-05-30","2021-06-03","2021-06-03","2021-06-01","2021-06-04","2021-06-03","2021-06-03","2021-12-06","2021-12-19","2022-02-27","2021-12-07","2020-09-30","2021-02-28","2021-03-05","2021-05-31","2021-06-04","2021-06-04","2021-06-04","2021-06-04","2021-06-01","2021-06-01","2021-06-01","2022-04-04","2020-06-09","2021-03-05","2021-03-05","2021-03-24","2022-02-27","2021-05-21","2021-05-21","2021-05-21","2021-05-30","2021-06-03","2021-06-03","2021-05-30","2021-03-03","2021-03-03","2021-03-03","2021-03-03","2020-06-10","2021-05-30","2021-05-30","2021-05-30","2021-05-30","2021-05-30","2021-05-30","2019-11-03","2019-11-03","2019-11-01","2019-11-01","2019-11-01","2019-11-01","2019-11-01","2019-11-01","2022-09-24","2022-09-24","2022-09-24","2022-07-22","2022-09-24","2022-09-24","2022-09-24"],"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":[["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","68382080501","TRAZODONE","TAB 50MG","30","Select","Select",""],["","31722082030","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","00172572960","FAMOTIDINE","TAB 40MG","30","Select","Select",""],["","","MIRTAZAPINE","TAB 15MG","","Select","Select",""],["","62332000931","VENLAFAXINE","TAB 37.5MG","30","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","00378395305","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00186077760","BRILINTA","TAB 90MG","60","Select","Select",""],["","68180051201","LISINOPRIL","TAB 2.5MG","30","Select","Select",""],["","00904404073","ASPIRIN","CHW 81MG","30","Select","Select",""],["","11822332470","RA","SUS ANTI-GAS","355","Select","Select",""],["","","ESOMEPRA","CAP 40MG DR","","Select","Select",""],["","","PROMETHAZINE","SUP 25MG","","Select","Select",""],["","00591079501","DICYCLOMINE","TAB 20MG","28","Select","Select",""],["","57896020401","ACETAMINOPHE","TAB 500MG","50","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":""}]}]}