{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LANCE LLOYD","gend":0,"add":"ATTN L MANGUM","city":"CHESTERFIELD","state":"VA","zip":"23832-9998","dob":"2000-10-04","age":"","mstatus":"","insh":"1087604*01","cliId":"","pno":7274032744,"cno":7274032744,"email":"","ename":"","eno":"","pphy":"AKBAR, SALMAN MD","ppno":8043305452,"pcpadd":"909 HIOAKS RD STE F\/G,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23225-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8043379950,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","F41.9","F64.9","F64.0","Z00.00","G89.29","R07.9","M79.652","F17.200","I49.8","Z68.23","M79.605","L60.0","L25.9","E78.5","NO DATA","F33.0","C25.9","Z79.890","Z04.9","M25.571","V00.138A","G47.00","D64.9","E55.9","R25.2","R00.2","R20.2","R00.0","F32.9","U07.1","J06.9","Z87.891","Z20.822","R51.9"],"date":["2023-06-05","2022-09-28","2022-12-07","2023-03-03","2023-05-03","2021-05-12","2021-05-12","2021-05-12","2022-03-08","2021-05-12","2021-06-30","2021-08-11","2022-06-24","2022-12-03","2023-01-06","2023-06-05","2023-02-17","2022-12-07","2021-05-07","2022-03-08","2022-03-28","2022-03-28","2022-10-31","2022-11-30","2022-11-30","2021-08-28","2022-03-08","2022-03-08","2023-09-06","2023-05-03","2023-09-06","2023-09-06","2023-09-06","2023-09-06","2023-09-06"],"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":[["","80681002000","MULTIVITAMIN","","30","Select","Select",""],["","53746051401","SPIRONOLACT","TAB 50MG","30","Select","Select",""],["","29300042110","AMITRIPTYLIN","TAB 50MG","30","Select","Select",""],["","00517042001","ESTRAD VAL","INJ 20MG\/ML","5","Select","Select",""],["","00093005401","BUSPIRONE","TAB 10MG","90","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","68180071909","AMLODIPINE","TAB 2.5MG","30","Select","Select",""],["","51672131201","MUPIROCIN","OIN 0.02","30","Select","Select",""],["","00143993905","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","08290309580","3ML LL SYRNG","MIS 18GX1.5\"","2","Select","Select",""],["","08290309628","SYRINGE LUER","MIS -LOK 1ML","20","Select","Select",""],["","08290305180","FILL NEEDLE","MIS 18GX1.5\"","2","Select","Select",""],["","08290305122","BD NEEDLES","MIS 25GX5\/8\"","25","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","65862050220","AMOX\/K CLAV","TAB 500-125","20","Select","Select",""],["","08290305145","BD NEEDLE","MIS 23GX1\"","2","Select","Select",""],["","00713022515","TRIAMCINOLON","CRE 0.001","45","Select","Select",""],["","29300042110","AMITRIPTYLINE HCL","50 MG","90","Select","Select",""],["","00517042001","ESTRADIOL VALERATE","20 MG\/ML","10","Select","Select",""],["","59651015201","PROGESTERONE","100 MG","90","Select","Select",""],["","53746051501","SPIRONOLACTONE","100 MG","90","Select","Select",""],["","53746051501","SPIRONOLACT TAB","100MG","30","Select","Select",""],["","80681002000","MULTIVITAMIN TAB","","30","Select","Select",""],["","29300042110","AMITRIPTYLIN TAB","50MG","90","Select","Select",""],["","00517042001","ESTRAD VAL INJ","20MG\/ML","5","Select","Select",""],["","00093005401","BUSPIRONE TAB","10MG","90","Select","Select",""],["","00143993905","AMOXICILLIN CAP","500MG","30","Select","Select",""],["","00093314705","CEPHALEXIN CAP","500MG","28","Select","Select",""],["","68180071909","AMLODIPINE TAB","2.5MG","30","Select","Select",""],["","51672131201","MUPIROCIN OIN","2%","30","Select","Select",""],["","52817033200","CYCLOBENZAPR TAB","10MG","30","Select","Select",""],["","08290309628","SYRINGE LUER MIS -LOK","1ML","12","Select","Select",""],["","08290305180","FILL NEEDLE MIS","18GX1.5\"","2","Select","Select",""],["","08290305122","BD NEEDLES MIS","25GX5\/8\"","25","Select","Select",""],["","08290305145","BD NEEDLE MIS","23GX1\"","2","Select","Select",""],["","65862050220","AMOX\/K CLAV TAB","500-125","20","Select","Select",""],["","00713022515","TRIAMCINOLON CRE","0.1%","45","Select","Select",""],["","24208091055","ERYTHROMYCIN","5 MG\/GRAM","3.5","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":""}]}]}