{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KAREN K GIBSON","gend":1,"add":"10184 ASHCAKE ROAD","city":"ASHLAND","state":"VA","zip":"23005-9998","dob":"1985-06-21","age":"","mstatus":"","insh":"1159826*01","cliId":"","pno":8047292844,"cno":8047292844,"email":"","ename":"","eno":"","pphy":"MORGAN, JOHN W MD","ppno":8048289357,"pcpadd":"417 N 11TH ST,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23293-9998","pcpcounty":"","pcpid":"","pcpname":"Monument Internal Medicine","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048287591,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25.471","M54.41","G43.109","F33.1","Z96.89","E66.01","G89.29","Z68.43","N93.9","F41.8","Z68.44","N93.8","Z32.02","M51.26","M54.17","R51.9","G89.4","Z79.891","F33.9","F60.5","M54.16","J01.00","J30.1","K80.20","M15.9","M25.561","M25.562","M53.3","G60.9","F41.9","R03.0","E66.9","K90.89","I10.","Z79.899","M47.816","M47.894","NO DATA","N39.0","F17.200","Z59.00","R10.9","F33.2","F41.1","M79.89","R25.2","I83.91","Z72.0","R73.03","F17.210","G62.89","R10.32","R07.9","M17.0","M25.462","M22.41","M22.42","Z01.818","I87.2","N92.6","T85.193A","K59.1","R10.84","G43.011","S60.011A","K21.9","N72.","Z01.812","Z20.822","F11.90","M17.10","M47.812","M17.11","S93.401A","E55.9","M62.838","M25.569","B35.0","E88.09","R74.01","M25.461","G43.709","G93.2"],"date":["2021-01-05","2022-08-23","2023-03-01","2023-06-27","2022-09-13","2023-05-05","2022-08-23","2021-01-29","2021-07-01","2021-07-01","2023-05-05","2021-05-19","2021-05-19","2022-07-28","2021-11-03","2023-08-07","2023-05-05","2022-06-13","2022-04-28","2022-04-28","2022-10-25","2021-10-18","2022-07-08","2021-10-28","2022-05-03","2022-07-28","2022-07-28","2022-07-28","2022-07-28","2023-01-06","2022-06-21","2022-06-21","2022-08-02","2023-05-05","2022-08-02","2023-04-17","2022-09-13","2023-01-06","2023-02-01","2023-02-01","2023-02-01","2023-02-01","2023-06-27","2023-09-13","2021-07-27","2021-07-13","2021-07-13","2021-07-13","2022-07-08","2022-07-08","2022-10-25","2023-02-01","2021-10-06","2022-11-18","2023-03-20","2022-01-12","2022-01-12","2021-06-18","2021-07-27","2021-06-18","2021-02-24","2022-06-06","2022-06-06","2022-09-30","2021-05-07","2023-05-05","2021-07-01","2021-10-25","2021-10-25","2022-08-23","2023-03-20","2022-09-13","2021-05-03","2021-05-03","2021-10-28","2022-11-18","2023-04-17","2023-06-23","2023-06-23","2023-06-23","2023-03-20","2023-08-07","2023-08-16"],"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":[["","00406052201","OXYCOD\/APAP","TAB 7.5-325","120","Select","Select",""],["","55513084301","AIMOVIG","INJ 140MG\/ML","1","Select","Select",""],["","50228017705","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","00023650110","UBRELVY","TAB 100MG","10","Select","Select",""],["","80777027399","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","68645052354","SERTRALINE","TAB 100MG","60","Select","Select",""],["","60505024801","MIRTAZAPINE","30 MG","30","Select","Select",""],["","16729030201","TRAZODONE","TAB 300MG","30","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","72205001690","PREGABALIN","CAP 200MG","90","Select","Select",""],["","50580049660","TYLENOL","TAB 325MG","60","Select","Select",""],["","42571012290","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","16729017217","AMITRIPTYLIN","TAB 25MG","30","Select","Select",""],["","68382052842","CHOLESTYRAM","POW 4GM","378","Select","Select",""],["","68645051054","HYDROCHLOROT","TAB 25MG","60","Select","Select",""],["","68180044701","QUETIAPINE","TAB 100MG","30","Select","Select",""],["","31722070190","LOSARTAN POT","TAB 50MG","45","Select","Select",""],["","59762045001","COLESTIPOL","TAB 1GM","30","Select","Select",""],["","16729044310","BUPROPN HCL","TAB 150MG XL","30","Select","Select",""],["","49281042250","FLUZONE QUAD","INJ 2022-23","0","Select","Select",""],["","00904600760","LORAZEPAM","TAB 0.5MG","2","Select","Select",""],["","68645052354","SERTRALINE HCL","100 MG","60","Select","Select",""],["","55513084301","AIMOVIG AUTOINJECTOR","140 MG\/ML","1","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","67386013051","VYEPTI","100 MG\/ML","1","Select","Select",""],["","16729044416","BUPROPION XL","300 MG","30","Select","Select",""],["","00093083201","CLONAZEPAM","0.5 MG","45","Select","Select",""],["","68180044701","QUETIAPINE FUMARATE","100 MG","30","Select","Select",""],["","00555071102","TRAZODONE HCL","300 MG","30","Select","Select",""],["","13668021730","ARIPIPRAZOLE","5 MG","30","Select","Select",""],["","59746033790","LOSARTAN-HYDROCHLOROTHIAZIDE","50-12.5 MG","180","Select","Select",""],["","24470091710","ERGOTAMINE-CAFFEINE","1 MG-100MG","15","Select","Select",""],["","59762045001","COLESTIPOL HCL","1 G","30","Select","Select",""],["","65162047810","NITROFURANTOIN MONO-MACRO","100 MG","14","Select","Select",""],["","31722071390","PANTOPRAZOLE SODIUM","40 MG","90","Select","Select",""],["","68645051054","HYDROCHLOROTHIAZIDE","25 MG","60","Select","Select",""],["","00115180301","HYDROXYZINE PAMOATE","25 MG","90","Select","Select",""],["","16571020150","DICLOFENAC SODIUM","75 MG","20","Select","Select",""],["","31722070190","LOSARTAN POTASSIUM","50 MG","45","Select","Select",""],["","00406052201","OXYCOD\/APAP TAB","7.5-325","120","Select","Select",""],["","50228017705","GABAPENTIN TAB","600MG","90","Select","Select",""],["","55513084301","AIMOVIG INJ","140MG\/ML","1","Select","Select",""],["","42806040021","METHYLPRED TAB","4MG","21","Select","Select",""],["","80777027399","MODERNA VAC INJ COVID-","19","0","Select","Select",""],["","60505024801","MIRTAZAPINE TAB","30MG","30","Select","Select",""],["","00023650110","UBRELVY TAB","100MG","10","Select","Select",""],["","68645052354","SERTRALINE TAB","100MG","60","Select","Select",""],["","16729030201","TRAZODONE TAB","300MG","30","Select","Select",""],["","72205001690","PREGABALIN CAP","200MG","90","Select","Select",""],["","50580049660","TYLENOL TAB","325MG","60","Select","Select",""],["","68382052842","CHOLESTYRAM POW","4GM","378","Select","Select",""],["","16729017217","AMITRIPTYLIN TAB","25MG","30","Select","Select",""],["","42571012290","LEVOCETIRIZI TAB","5MG","30","Select","Select",""],["","68180044701","QUETIAPINE TAB","100MG","30","Select","Select",""],["","68645051054","HYDROCHLOROT TAB","25MG","60","Select","Select",""],["","31722070190","LOSARTAN POT TAB","50MG","45","Select","Select",""],["","59762045001","COLESTIPOL TAB","1GM","30","Select","Select",""],["","16729044310","BUPROPN HCL TAB","150MG XL","30","Select","Select",""],["","49281042250","FLUZONE QUAD INJ","2022-23","0","Select","Select",""],["","00093342501","LORAZEPAM TAB","0.5MG","2","Select","Select",""],["","63646001004","KETOCONAZOLE","2 %","120","Select","Select",""],["","00093081101","NORTRIPTYLINE HCL","25 MG","60","Select","Select",""],["","33342009441","RIZATRIPTAN","10 MG","9","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":""}]}]}