{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AMBER   N DEATON","gend":1,"add":"12401 GRAHAM MEADOWS DR","city":"HENRICO","state":"VA","zip":"23233-9998","dob":"1982-01-27","age":"","mstatus":"","insh":"20069497*01","cliId":"","pno":"757\/903-1731","cno":"757\/903-1731","email":"","ename":"","eno":"","pphy":"POWERS, KEVIN L MD","ppno":"804\/262-4763","pcpadd":"4000 GLENSIDE DR STE A","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23228,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/264-9683","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","F14.10","F13.10","F43.10","F39.","M54.5","M47.26","M54.42","M53.86","M54.41","F10.20","N76.1","F11.21","H66.91","B37.3","Z01.810","I45.19","M54.89","M51.27","M47.816","M79.604","M62.81","G89.29","I78.1","G25.81","A60.00","Z87.891","H92.01","N89.8","NO DATA","A60.04","J32.9","R51.9","N76.0","M54.16","N30.90","Z30.09","Z01.419","Z20.822","L04.9","M54.2","H92.02","J02.9","Z11.59","Z20.2","Z32.01","R32.","H81.90","N39.3","N92.5","Z11.3","Z32.02"],"date":["2022-01-24","2021-10-11","2021-09-12","2021-09-09","2021-09-09","2021-09-23","2022-09-30","2021-10-11","2021-10-11","2022-11-09","2022-01-24","2021-01-14","2022-08-18","2021-07-26","2022-04-27","2022-09-08","2022-09-08","2022-09-16","2022-11-17","2022-09-16","2022-11-09","2022-11-09","2022-11-09","2021-07-12","2022-07-21","2022-07-21","2021-07-26","2021-07-26","2022-05-05","2022-05-13","2020-11-04","2021-09-06","2022-01-08","2022-01-04","2022-11-17","2022-07-21","2022-07-21","2022-10-05","2021-09-06","2020-12-09","2020-12-09","2021-11-19","2022-01-08","2022-01-08","2022-05-05","2022-05-05","2022-04-21","2022-04-21","2022-04-27","2022-04-27","2022-04-27","2022-04-27"],"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":[["","72578008801","NYSTAT\/TRIAM","OIN ","15","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","16729008110","NALTREXONE","TAB 50MG","30","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","60","Select","Select",""],["","70436001002","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","80777027310","MODERNA","INJ COVID-19","0","Select","Select",""],["","64380074705","PRAMIPEXOLE","TAB 0.25MG","90","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","65862039110","ONDANSETRON","TAB 8MG ODT","20","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","69543025810","PREPLUS","TAB 27-1MG","28","Select","Select",""],["","68180065208","DOXYCYC","CAP 100MG","14","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","40","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","10","Select","Select",""],["","66993060536","ETONOGESTREL","MIS ETHY EST","1","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","30","Select","Select",""],["","23155022701","ACYCLOVIR","TAB 400MG","15","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","4","Select","Select",""],["","47781035703","BUPREN\/NALOX","MIS 8-2MG","4","Select","Select",""],["","00096070735","DRYSOL","SOL 0.2","35","Select","Select",""],["","59762453802","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","14539067306","DIFLUNISAL","TAB 500MG","60","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","41167432005","ALLEGRA-D","TAB 24 HOUR","30","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","20","Select","Select",""],["","00536118365","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","69230030001","ALLERGY","TAB 180MG","30","Select","Select",""],["","24208063110","NEO\/POLY\/HC","SOL 1% OTIC","10","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","15","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":""}]}]}