{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TARSHELLE  T HARRIS","gend":1,"add":"300 PEACE LILY LN APT 302","city":"RICHMOND","state":"VA","zip":"23223-9998","dob":"1976-03-13","age":"","mstatus":"","insh":"1135710*01","cliId":"","pno":8042374353,"cno":8042374353,"email":"","ename":"","eno":"","pphy":"BOHANNON, ARLINE MD","ppno":8048289357,"pcpadd":"417 N 11TH ST","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23298-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048284926,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z90.11","Z97.5","Z78.0","Z85.3","M25.552","M79.605","Z12.11","K64.0","I51.7","R94.31","L25.9","K80.20","Z01.411","I10.","E28.319","Z30.432","R87.619","L03.032","M54.5","E66.9","G57.02","Z79.01","M70.62","M32.9","M87.051","M87.052","Z68.35","R35.0","I26.99","Z86.711","Z79.899","Z08.","Z86.000","Z86.718","M16.0","Z68.33","M16.12","M76.02","R07.9","R06.02","I48.91","E78.5","M25.551","G89.29","Z01.812","Z20.822","M32.14","M65.30","R07.2","M54.16","R53.1","M87.88","C50.811","R21."],"date":["2021-06-11","2021-02-01","2021-02-01","2021-02-23","2022-01-24","2021-03-12","2021-04-16","2021-04-16","2021-11-21","2021-11-21","2022-03-20","2023-01-31","2021-02-23","2023-03-30","2021-02-23","2021-02-23","2021-02-23","2021-06-22","2021-05-20","2022-01-24","2021-06-11","2023-01-12","2022-01-24","2022-01-24","2022-01-24","2022-01-24","2022-01-24","2023-01-12","2023-01-12","2021-11-30","2021-08-03","2021-06-11","2021-06-11","2021-06-11","2021-11-30","2021-07-22","2021-07-28","2021-07-28","2021-12-03","2021-12-03","2021-11-30","2021-11-30","2022-01-24","2021-04-14","2021-04-14","2021-04-14","2021-08-03","2021-08-03","2021-11-21","2021-01-13","2021-01-13","2021-01-13","2021-10-18","2022-03-20"],"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":[]},{"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":[["","00781517501","MYCOPHENOLAT","TAB 500MG","180","Select","Select",""],["","68462035701","POT CHLORIDE","CAP 10MEQ ER","180","Select","Select",""],["","68180097903","LISINOPRIL","TAB 40MG","90","Select","Select",""],["","53746051105","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","63304072190","DILTIAZEM","CAP 300MG ER","30","Select","Select",""],["","51672402901","WARFARIN","TAB 2.5MG","40","Select","Select",""],["","68382009601","HYDROXYCHLOR","TAB 200MG","60","Select","Select",""],["","55111012205","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","68382020906","ANASTROZOLE","TAB 1MG","30","Select","Select",""],["","67253090210","ALPRAZOLAM","TAB 1MG","1","Select","Select",""],["","00904674860","BISACODYL","TAB 5MG EC","4","Select","Select",""],["","61269073063","MICONAZOLE 7","CRE 0.02","45","Select","Select",""],["","00093314505","CEPHALEXIN","CAP 250MG","28","Select","Select",""],["","45802086802","POLYETH GLYC","POW 3350 NF","238","Select","Select",""],["","59676058015","JANSSEN VACC","INJ COVID-19","0","Select","Select",""],["","49281072110","FLUBLOK QUAD","INJ 2021-22","0","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","00363032908","WAL-DRYL","TAB 25MG","24","Select","Select",""],["","00904530660","BANOPHEN","CAP 25MG","20","Select","Select",""],["","43547036809","VALSARTAN","TAB 80MG","30","Select","Select",""],["","00378427677","VALACYCLOVIR","TAB 1GM","4","Select","Select",""],["","29300012810","HYDROCHLOROTHIAZIDE","25 MG","30","Select","Select",""],["","29300046810","CLONIDINE HCL","0.1 MG","60","Select","Select",""],["","51672402901","WARFARIN SODIUM","2.5 MG","45","Select","Select",""],["","68382009601","HYDROXYCHLOROQUINE SULFATE","200 MG","60","Select","Select",""],["","11877001140","BINAXNOW COVID-","19 AG SELF TEST","8","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":""}]}]}