{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAMMY   D BROWN","gend":1,"add":"1934 RAVEN ST","city":"RICHMOND","state":"VA","zip":"23223-9998","dob":"1965-12-15","age":"","mstatus":"","insh":"2263093*01","cliId":"","pno":"804\/779-5529","cno":"","email":"","ename":"","eno":"","pphy":"ACHARYA, ASHU MD","ppno":"804\/254-3500","pcpadd":"2116 W LABURNUM AVE","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23227,"pcpcounty":"","pcpid":"","pcpname":"MCV ASSOCIATED PHYSICIANS","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/254-1616","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R00.0","R94.31","E10.11","R63.4","J96.00","E11.00","NO DATA","R53.1","K59.00","R73.9","E10.10","Z91.14","K52.9","F32.9","N17.9","E87.6","E83.39","B37.3","J96.01","E78.5","E86.0","E11.65","E86.1","I95.1","E13.8","Z79.4","E11.9","I10.","Z68.1","R11.2","E13.10","E13.00","V58.69","N28.9","R19.7","E13.21","Z11.59","D72.829","Z91.128","Z91.11","K62.89","R42.","R51.","Z01.419","G93.41","E87.8","R41.82","K76.89","E46.","A41.9","D64.9","I49.9","Z92.29","E55.9","R68.89","H93.299","G82.50","E11.21","G47.00","Z79.899","R65.21","E87.2","E87.3","E87.5","D50.9","I95.9","R93.1","R63.6","Z91.19","U07.1","F43.20","E11.40","E43.","F33.1","Z86.79","R10.10","K59.1","R55.","I65.23","E11.42","G45.1","E09.10","E10.9","E83.42","I51.7","I34.0","A08.4","E11.22","A59.9","N39.0","F33.9","N18.6","E86.9","D63.1","Z20.822","R64.","R52.","Z11.4","Z86.39","Z12.11","Z12.12","Z12.31","E11.69"],"date":["2022-10-07","2022-08-24","2020-01-24","2022-09-20","2020-01-24","2020-06-21","2022-09-20","2020-06-25","2020-06-26","2022-01-28","2022-07-20","2022-04-24","2022-09-20","2022-07-21","2022-04-24","2022-10-27","2022-04-24","2022-07-22","2022-01-19","2022-08-24","2022-10-27","2022-10-27","2020-06-25","2020-06-25","2020-06-25","2022-10-27","2020-07-21","2020-07-21","2022-10-05","2020-06-24","2022-04-25","2020-06-20","2020-06-20","2020-06-20","2022-10-07","2020-06-20","2020-06-25","2020-06-21","2020-06-20","2020-06-20","2020-06-25","2022-08-24","2020-06-25","2021-09-13","2022-01-19","2021-11-24","2022-07-22","2020-01-22","2020-01-22","2020-06-20","2022-05-02","2020-06-20","2021-06-07","2022-09-20","2021-06-07","2021-06-07","2020-01-21","2020-06-25","2020-06-25","2022-04-24","2020-01-20","2022-01-19","2020-01-20","2020-01-20","2022-09-20","2022-07-22","2020-01-21","2022-10-05","2021-11-22","2022-01-19","2022-07-21","2022-10-07","2022-10-06","2022-08-16","2022-09-20","2022-04-25","2022-04-25","2022-07-22","2022-07-22","2022-07-22","2022-07-22","2022-07-22","2022-08-24","2022-01-30","2022-04-29","2022-04-29","2022-04-24","2022-04-24","2022-04-24","2022-04-24","2022-04-27","2022-01-27","2022-01-27","2022-01-27","2022-01-27","2022-01-27","2022-07-20","2022-09-20","2022-09-20","2022-09-20","2022-09-20","2022-09-20","2022-09-20"],"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":[["","","ONETOUCH","TES VERIO","","Select","Select",""],["","65862006299","METOPROL","TAB 25MG","30","Select","Select",""],["","","INSULIN","INJ FLEXPEN","","Select","Select",""],["","","LANTUS","INJ 100\/ML","","Select","Select",""],["","73562011101","ZENPEP","CAP 15000UNT","90","Select","Select",""],["","","BD  PEN NEEDL","MIS 32GX5\/32","","Select","Select",""],["","68180035206","SERTRALINE","TAB 50MG","30","Select","Select",""],["","00002880359","HUMULIN","INJ 70\/30KWP","9","Select","Select",""],["","69238106901","POT  CHLORIDE","TAB 20MEQ ER","30","Select","Select",""],["","","BASAGLAR","INJ 100UNIT","","Select","Select",""],["","16729017001","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","","VITAMIN","CAP 50000UNT","","Select","Select",""],["","57237000830","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","08489831110","PEN  NEEDLES","MIS 31GX6MM","100","Select","Select",""],["","","HUMALOG","INJ 100\/ML","","Select","Select",""],["","49100036374","CULTURELLE","CAP IMMUNITY","30","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","16","Select","Select",""],["","00536120215","LIDOCAINE","PAD 0.04","15","Select","Select",""],["","","NOVOLIN","INJ 100 UNIT","","Select","Select",""],["","","LOSARTAN","TAB 50MG","","Select","Select",""],["","57896020401","ACETAMINOPHE","TAB 500MG","20","Select","Select",""],["","","NOVOLOG","INJ FLEXPEN","","Select","Select",""],["","65162019010","NAPROXEN","TAB 500MG","20","Select","Select",""],["","","LEVEMIR","INJ FLEXTOUC","","Select","Select",""],["","","ATORVASTATIN","TAB 10MG","","Select","Select",""],["","08508200005","OMNIPOD","MIS 5 PACK","45","Select","Select",""],["","00046087221","PREMARIN","CRE 0.625MG","30","Select","Select",""],["","00006057761","JANUMET","TAB 50-1000","180","Select","Select",""],["","57599000200","FREESTYLE    MIS READER","MIS READER","1","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","2","Select","Select",""],["","51672128402","TRIAMCINOLON","OIN 0.001","60","Select","Select",""],["","69543026810","VIRT-PHOS","TAB 250 NEUT","6","Select","Select",""],["","","TOUJEO","INJ 300IU\/ML","","Select","Select",""],["","","VRAYLAR","CAP 1.5MG","","Select","Select",""],["","","VENLAFAXINE","CAP 37.5 ER","","Select","Select",""],["","","FLUOXETINE","CAP 40MG","","Select","Select",""],["","","FREESTYLE    TES LITE","TES LITE","","Select","Select",""],["","","PEG-3350\/KCL","SOL \/SODIUM","","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":""}]}]}