{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARLA VAUGHAN","gend":1,"add":"8331 CALYPSO LN","city":"CHESTERFIELD","state":"VA","zip":"23838-9998","dob":"1994-01-08","age":"","mstatus":"","insh":"2245928*01","cliId":"","pno":"804\/426-2594","cno":"","email":"","ename":"","eno":"","pphy":"ROBERTS, JEFFREY MD","ppno":"804\/739-6142","pcpadd":"13540 HULL STREET RD","pcpcity":"MIDLOTHIAN","pcpstate":"VA","pcpzip":23112,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS ST. FRANCIS FAMILY MEDICINE CENTER","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/739-8923","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["B37.3","N30.00","L73.8","L81.9","L68.0","G35.","M79.604","M79.605","O26.873","O99.353","O34.33","O40.3XX0","Z3A.37","O40.9XX0","Z37.0","Z3A.39","R46.89","R40.4","G47.10","G93.89","R56.9","Z92.89","L66.8","L29.8","F44.5","Z30.42","Z32.02","Z79.899","R20.8","N39.3","Z04.9","R32.","L66.1","L53.8","Z01.411","B37.9","R63.5","Z11.3","N32.81","N39.46","R35.0","R35.1","L81.0","L73.1","G47.419","R41.3","G31.89","F43.21","N81.10","N81.6","F43.20","N93.9","M79.89","Z34.93","M79.10","N76.0","B96.89","G43.819","M79.2","Z39.1","Z34.82","Z34.83","O36.8130","Z36.89","Z3A.38","D62.","O99.02","O70.1","Z91.040","R25.1","L65.9","Z86.69","Z11.59","Z76.89","Z01.419"],"date":["2022-08-30","2021-11-29","2022-02-08","2022-02-08","2022-02-08","2022-05-14","2022-04-18","2022-04-18","2020-01-23","2020-02-06","2020-02-06","2020-02-13","2020-02-06","2020-02-14","2020-02-14","2020-02-14","2020-09-17","2020-09-14","2020-10-02","2020-06-24","2020-10-02","2021-06-03","2022-05-09","2022-05-09","2020-08-19","2020-12-23","2021-09-23","2022-01-19","2022-05-09","2022-04-14","2021-11-22","2022-04-14","2022-05-09","2022-05-09","2022-07-12","2022-07-12","2022-07-12","2022-07-12","2021-06-03","2021-11-22","2021-06-03","2021-06-03","2021-10-19","2021-10-19","2022-01-19","2021-10-13","2021-10-13","2021-10-13","2021-11-22","2021-11-22","2021-06-04","2021-10-20","2022-04-19","2020-02-12","2021-07-17","2021-07-29","2021-07-29","2022-01-19","2022-01-19","2020-01-29","2020-01-29","2020-01-29","2020-02-08","2020-02-08","2020-02-13","2020-02-13","2020-02-13","2020-02-13","2020-02-13","2020-10-02","2021-02-24","2021-02-24","2021-02-24","2021-02-24","2021-07-09"],"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":[["","00316022130","NYSTATIN","CRE 100000","30","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","59572082030","ZEPOSIA","CAP .92MG","30","Select","Select",""],["","69367013506","GABAPENTIN","TAB 800MG","90","Select","Select",""],["","00002143611","EMGALITY","INJ 120MG\/ML","1","Select","Select",""],["","68462053253","CLOBETASOL","SOL 0.0005","50","Select","Select",""],["","49884072703","DOXYCYC","CAP 100MG","30","Select","Select",""],["","42192015101","HYDROQUINONE","CRE 0.04","28","Select","Select",""],["","59762453701","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","70710122600","AMITRIPTYLIN","TAB 25MG","90","Select","Select",""],["","00832712415","DIVALPROEX","TAB 500MG DR","60","Select","Select",""],["","51672400301","NORTRIPTYLIN","CAP 50MG","30","Select","Select",""],["","00168034646","TERCONAZOLE","CRE 0.004","45","Select","Select",""],["","45802073684","CLINDAMY\/BEN","GEL 1.2-5%","45","Select","Select",""],["","00054001925","PREDNISONE","TAB 50MG","3","Select","Select",""],["","00378808420","TRETINOIN","CRE 0.001","40","Select","Select",""],["","42043016003","MODAFINIL","TAB 100MG","60","Select","Select",""],["","68546032512","COPAXONE","INJ 40MG\/ML","12","Select","Select",""],["","51862094205","DIAZEPAM","TAB 5MG","2","Select","Select",""],["","58468021004","AUBAGIO","TAB 14MG","30","Select","Select",""],["","00469260130","MYRBETRIQ","TAB 25MG","30","Select","Select",""],["","00069024230","TOVIAZ","TAB 4MG","30","Select","Select",""],["","00472015515","NYSTAT\/TRIAM","OIN ","15","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","00023485745","VANIQA","CRE 0.139","45","Select","Select",""],["","76385012350","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","51672402601","KETOCONAZOLE","TAB 200MG","21","Select","Select",""],["","51672128202","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","68180051202","LISINOPRIL","TAB 2.5MG","30","Select","Select",""],["","70954000520","OXYBUTYNIN","TAB 5MG","30","Select","Select",""],["","00472037945","CLOTRIM\/BETA","CRE DIPROP","45","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","69452023420","PROGESTERONE","CAP 200MG","30","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","5","Select","Select",""],["","62756052169","SUMATRIPTAN","TAB 50MG","9","Select","Select",""],["","00378696112","GLATIRAMER","INJ 40MG\/ML","12","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":""}]}]}