{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN METZINGER","gend":0,"add":"2391 PONY FARM ROAD","city":"MAIDENS","state":"VA","zip":"23102-9998","dob":"1985-06-28","age":"","mstatus":"","insh":"2161965*01","cliId":"","pno":"804\/874-8969","cno":"804\/874-8969","email":"","ename":"","eno":"","pphy":"JOHNSON, RUSSELL MD","ppno":"804\/379-1500","pcpadd":"12731 STONE VILLAGE WAY","pcpcity":"MIDLOTHIAN","pcpstate":"VA","pcpzip":23113,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/379-1633","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R51.","Q28.3","R41.82","Z11.59","G43.119","G44.1","I10.","M54.5","R53.1","R20.0","M62.81","M25.551","Q04.9","Q76.49","Z98.890","R33.9","R20.2","M43.17","M54.16","F44.4","M47.817","G43.909","Z85.828","E78.5","F41.9","V62.84","F43.25","R42.","R40.4","R07.9","R26.2","G43.009","G44.221","D18.00","G62.9","R20.8","Z91.81","G44.209","F44.7","R44.3","Z86.79","F29.","F33.2","R55.","R09.02","B34.9","Z15.89","NO DATA","F43.8","I63.9","H53.2","R11.2","R51.9","G44.009","Z68.35","I07.1","G43.809","G89.29","M54.41","M54.42","D18.02","R07.89","R00.2","R07.2","M48.07","Z79.899","E78.2","Z68.33","M54.2","R26.81","G43.109","Z68.36","G93.9","H53.9","H55.00","L30.9","B35.4","R44.0","Z20.822","Z72.89","Q76.2","F32.89","E66.01","F17.210","F32.9","F90.9","R73.9","Z68.37","Z86.73","R06.02","W19.XXXA","Z88.0","R56.9","I62.9","F41.1","M51.27","F44.6","G44.229","M54.6","H52.13","Z97.3","I69.911","R29.898","G25.71","H47.233","I63.50","Z76.0","I45.10","G43.019","I48.91","R45.851","I61.6","R11.0","Z68.32","M79.609","L03.319","R11.10","E66.9","Z79.891","H53.8","F33.41"],"date":["2020-07-30","2022-04-26","2020-07-19","2020-07-25","2020-09-03","2020-07-23","2022-04-26","2020-12-17","2020-12-17","2020-12-14","2021-03-17","2020-07-29","2020-07-30","2020-07-29","2021-04-13","2020-07-29","2020-07-29","2020-12-12","2020-09-01","2021-08-23","2020-12-12","2021-06-12","2020-12-12","2022-01-08","2022-04-26","2021-04-26","2022-05-11","2021-12-27","2021-05-14","2020-06-12","2020-07-27","2022-04-26","2021-09-03","2022-04-26","2021-04-05","2021-03-17","2021-03-17","2021-01-12","2021-03-19","2021-04-13","2021-04-13","2022-06-15","2021-06-29","2021-10-20","2021-10-20","2021-12-27","2022-04-26","2022-04-26","2022-09-12","2021-05-15","2021-06-13","2021-09-29","2022-07-07","2021-09-29","2021-10-20","2021-10-21","2022-01-08","2022-04-18","2022-04-18","2022-04-18","2022-04-26","2020-06-12","2020-09-29","2020-09-29","2020-08-03","2022-01-08","2020-09-29","2020-09-29","2021-03-22","2021-05-14","2021-05-15","2022-01-08","2021-10-22","2021-10-22","2021-07-30","2022-09-02","2022-09-02","2021-04-05","2021-10-20","2021-04-03","2021-04-03","2021-04-03","2021-06-12","2021-06-12","2021-06-23","2021-06-12","2021-06-12","2021-06-13","2021-06-12","2020-06-26","2020-07-25","2020-07-25","2020-07-27","2020-11-03","2022-06-15","2020-10-19","2020-12-17","2021-04-13","2021-09-21","2021-10-22","2021-10-22","2020-09-15","2020-12-16","2021-06-30","2021-10-22","2022-01-08","2022-01-11","2020-07-21","2020-07-20","2020-07-21","2021-06-23","2020-03-04","2020-03-04","2020-06-16","2020-07-26","2020-09-24","2021-12-27","2022-01-08","2022-01-08","2022-01-08","2022-06-08"],"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":[["","70377002811","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","70710122501","AMITRIPTYLIN","TAB 10MG","60","Select","Select",""],["","31722070290","LOSARTAN","TAB 100MG","30","Select","Select",""],["","67877022310","GABAPENTIN","CAP 300MG","270","Select","Select",""],["","65862070360","ZIPRASIDONE","CAP 40MG","60","Select","Select",""],["","23155000810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","42806016105","HYDROXYZ","TAB 50MG","30","Select","Select",""],["","16729020001","BUSPIRONE","TAB 5MG","60","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","51991081701","PROPRANOLOL","CAP 60MG ER","90","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","71093014005","METHOCARBAM","TAB 500MG","30","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","15","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","00093321930","KETOCONAZOLE","CRE 0.02","30","Select","Select",""],["","10006073043","VITAMIN","TAB 1000MCG","90","Select","Select",""],["","68180021609","LOSARTAN\/HCT","TAB 100-12.5","30","Select","Select",""],["","33342008507","OLANZAPINE","TAB 15MG ODT","30","Select","Select",""],["","59746012106","MECLIZINE","TAB 25MG","30","Select","Select",""],["","63402030630","LATUDA","TAB 60MG","30","Select","Select",""],["","31604002732","B-12","CAP 1000MCG","30","Select","Select",""],["","59267100003","PFIZER","INJ COVID-19","0","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","20","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","60","Select","Select",""],["","69097012203","TOPIRAMATE","TAB 25MG","180","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","30","Select","Select",""],["","00054418325","DEXAMETHASON","TAB 2MG","5","Select","Select",""],["","00904671980","ACETAMINOPHE","TAB 325MG","30","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","7","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","4","Select","Select",""],["","65162074510","PROMETHAZINE","TAB 12.5MG","60","Select","Select",""],["","00904555159","BANOPHEN","TAB 25MG","30","Select","Select",""],["","59779036751","SLEEP","TAB 25MG","30","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","40","Select","Select",""],["","49281042050","FLUZONE","INJ 2020-21","0","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":""}]}]}