{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"INDIA   L PRESSLEY","gend":1,"add":"1612 COLUMBIA ST","city":"RICHMOND","state":"VA","zip":"23224-9998","dob":"1986-08-30","age":"","mstatus":"","insh":"3035255*01","cliId":"","pno":"804\/938-7656","cno":"","email":"","ename":"","eno":"","pphy":"MEYERS, SARAH E PA","ppno":"804\/298-3460","pcpadd":"115 S 115TH ST STE 501","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23219,"pcpcounty":"","pcpid":"","pcpname":"COMMONWEALTH INTERNAL MEDICINE ASSOCIATES","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/344-0980","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","F43.10","M54.5","R50.9","R05.","T31.0","T21.22XA","T21.21XA","NO DATA","R19.7","S93.401A","E11.8","Z68.44","I10.","B34.2","Z79.4","Z68.45","T24.211A","E11.9","E66.01","Z20.822","N93.9","N84.0","N30.90","D50.0","M54.9","M79.2","J40.","G89.29","R10.11","R10.12","F41.1","F33.2","M65.312","Z23.","L03.317","Z13.21","R07.82","R07.9","Z11.3","J45.41","M48.00","N92.0","G47.33","R00.0","R55.","N39.0","R11.10","E78.5","R10.10","E10.8","E55.9","L02.211","A41.9","J06.9","B97.29","L03.311","D64.9","Z79.2","T81.89XA","L02.91","R10.30","G89.4","R10.9","E87.2","F39.","R65.20","Z87.891","Z88.0","L02.414","E11.628","K21.9","K59.00","M79.3","D25.9","R10.31","L02.92","R59.0","Z01.818","R07.89","N30.00","E87.1","V58.69","E88.81","E87.8","D50.9","E86.0","R05.9","Z11.59","D25.1","R09.02","R06.02","Z48.816","N93.8","E11.65","I50.9","R29.898","J02.9","R68.83","R35.0","H53.8","Z28.310","R79.89","J39.9","D25.2","N85.4","K80.20","R10.13"],"date":["2021-01-19","2020-09-03","2020-11-11","2021-01-07","2021-01-07","2021-03-19","2021-03-04","2021-03-04","2022-07-16","2021-12-02","2020-03-07","2022-02-09","2020-01-15","2022-07-16","2020-02-04","2022-07-16","2022-07-16","2021-03-02","2021-12-02","2022-07-16","2022-05-21","2022-02-09","2022-02-09","2021-12-12","2022-02-02","2021-04-02","2020-02-04","2020-02-04","2021-04-02","2020-04-16","2020-04-16","2020-10-01","2020-10-01","2020-10-19","2020-10-19","2020-10-19","2020-10-19","2021-01-03","2022-04-06","2021-04-02","2021-04-02","2021-04-02","2021-12-02","2021-04-02","2022-07-16","2021-06-27","2022-05-21","2021-12-02","2021-12-02","2021-12-02","2019-03-07","2019-01-31","2019-06-07","2019-11-20","2022-05-21","2019-11-20","2019-06-07","2022-02-09","2019-06-07","2019-06-08","2019-04-04","2019-05-09","2019-03-07","2022-08-13","2019-11-19","2019-11-19","2019-11-19","2019-11-19","2022-08-13","2019-03-17","2019-04-03","2019-04-03","2019-04-03","2019-04-03","2019-04-03","2019-04-03","2019-04-03","2019-04-03","2022-02-07","2022-05-21","2022-07-16","2022-07-16","2022-07-16","2022-07-16","2022-07-16","2022-07-16","2022-07-16","2022-07-16","2022-02-07","2022-02-09","2022-04-06","2022-05-21","2022-02-28","2022-02-28","2022-05-21","2022-05-21","2022-05-21","2022-05-21","2022-05-21","2022-05-21","2022-05-21","2022-05-21","2022-04-06","2022-04-06","2022-02-01","2022-02-01","2022-08-13","2022-08-13"],"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":[["","59762005601","MEDROXYPR","TAB 10MG","50","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","00088222033","LANTUS","INJ 100\/ML","50","Select","Select",""],["","11917004813","INSULIN","MIS 1ML\/31G","60","Select","Select",""],["","00002751001","HUMALOG","INJ 100\/ML","20","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","20","Select","Select",""],["","65862001905","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","9","Select","Select",""],["","","HYDROCHLOROT","TAB 25MG","","Select","Select",""],["","65702071110","ACCU-CHEK","TES GUIDE","100","Select","Select",""],["","68382004101","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA BL","100","Select","Select",""],["","27808003502","HYDROCO\/APAP","TAB 5-325MG","28","Select","Select",""],["","68462010630","ONDANSETRON","TAB 8MG","10","Select","Select",""],["","68180051703","LISINOPRIL","TAB 40MG","30","Select","Select",""],["","65862001205","SERTRALINE","TAB 50MG","90","Select","Select",""],["","","METFORMIN","TAB 500MG","","Select","Select",""],["","70710148301","URSODIOL","CAP 300MG","60","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","","GABAPENTIN","CAP 300MG","","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","00713028031","BACITRACIN","OIN 500\/GM","28","Select","Select",""],["","","DOXYCYC","CAP 100MG","","Select","Select",""],["","67877012425","SILVER","CRE 0.01","25","Select","Select",""],["","61570013120","SILVADENE","CRE 0.01","20","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","15","Select","Select",""],["","14428000003","BACITRAYCIN","OIN 500\/GM","28","Select","Select",""],["","","SYMBICORT","AER 160-4.5","","Select","Select",""],["","53746027201","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","","TRAMADOL","TAB 50MG","","Select","Select",""],["","00363064534","LOPERAMIDE","SUS 1MG\/7.5","120","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","00363053112","PAIN","TAB 500MG","100","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","90","Select","Select",""],["","11917009215","FERROUS","TAB 325MG","30","Select","Select",""],["","00904672059","ACETAMIN","TAB 500MG","20","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","50","Select","Select",""],["","","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","","DICYCLOMINE","CAP 10MG","","Select","Select",""],["","","CLINDAMYCIN","CAP 300MG","","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","60","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","08290320122","BD  PEN NEEDL","MIS 32GX4MM","200","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","6","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","00904576960","ARTHRTS","TAB 650MG","100","Select","Select",""],["","00078043305","FOCALIN","CAP 30MG","30","Select","Select",""],["","50580029710","TYLENOL","TAB 650MG","100","Select","Select",""],["","00781268701","DEXMETHYLPH","CAP 30MG ER","30","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","16","Select","Select",""],["","56151014701","TRUPLUS","MIS 33G","300","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","15","Select","Select",""],["","56151146001","TRUE","TES GLUCOSE","200","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","69543025216","VIRTUSSIN","SOL 100-10\/5","100","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}