{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA   C COWAN","gend":1,"add":"11618 E BRIAR PATCH DR","city":"MIDLOTHIAN","state":"VA","zip":"23113-9998","dob":"1962-01-20","age":"","mstatus":"","insh":"20065959*01","cliId":"","pno":"804\/269-2806","cno":"804\/269-2806","email":"","ename":"","eno":"","pphy":"CELLA, CAROLINE P MD","ppno":"804\/320-1333","pcpadd":"1471 JOHNSTON WILLIS DRIVE","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23235,"pcpcounty":"","pcpid":"","pcpname":"Primary Health Group - Johnston-Willis","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/320-5606","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N81.84","N39.3","M25.612","M25.512","M75.122","M75.42","L60.3","B35.1","F33.9","F41.9","R41.89","Z62.820","G47.33","G25.0","Z12.11","K44.9","NO DATA","G47.30","Z98.890","N39.41","R29.898","Z47.89","I10.","Z68.34","M62.81","M54.5","M25.561","Z68.35","M17.11","E66.9","R25.1","M79.605","N30.00","H61.22","H60.92","H81.13","D50.9","Z68.33","H40.013","Z96.1","M79.662","R60.0","R42.","J01.90","J04.10","S46.012A","T78.40XA","G89.18","Z48.89","Z01.419"],"date":["2020-09-04","2020-09-15","2020-10-20","2020-09-16","2021-09-08","2020-09-16","2020-06-23","2020-06-23","2022-02-22","2022-02-18","2022-02-18","2022-02-18","2022-06-27","2021-06-11","2022-06-16","2022-06-16","2022-06-16","2022-06-16","2021-09-08","2020-09-15","2020-09-14","2020-09-24","2022-02-15","2020-09-30","2021-07-07","2021-07-07","2021-04-19","2021-06-02","2021-07-07","2022-02-15","2022-02-15","2021-06-09","2021-10-31","2021-10-31","2021-10-31","2020-08-07","2020-08-07","2020-08-07","2021-04-05","2021-02-01","2021-06-09","2021-08-12","2020-07-31","2020-09-30","2020-09-30","2020-05-29","2020-05-29","2020-05-29","2020-07-23","2021-02-22"],"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":[["","69315090401","LORAZEPAM","TAB 0.5MG","30","Select","Select",""],["","64764075030","TRINTELLIX","TAB 20MG","30","Select","Select",""],["","00603548432","PROPRANOLOL","TAB 40MG","60","Select","Select",""],["","50111056003","TRAZODONE","TAB 50MG","30","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","61442010301","DICLOFENAC","TAB 75MG DR","30","Select","Select",""],["","29300012501","MELOXICAM","TAB 15MG","30","Select","Select",""],["","24208063562","NEO\/POLY\/HC","SUS 1% OTIC","10","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","49281042150","FLUZONE","INJ 2021-22","0","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00406324301","HYDROMORPHON","TAB 2MG","28","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","21","Select","Select",""],["","00527293437","PREDNISONE","TAB 20MG","3","Select","Select",""],["","65862064130","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","49281072010","FLUBLOK","INJ 2020-21","0","Select","Select",""],["","00904555960","PRIMIDONE","TAB 50MG","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":""}]}]}