{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARIE  W HALL","gend":1,"add":"5105 MERIDAN AVE RM 310","city":"PETERSBURG","state":"VA","zip":"23803-9998","dob":"1980-01-13","age":"","mstatus":"","insh":"1176000*01","cliId":"","pno":8043079985,"cno":8043079985,"email":"","ename":"","eno":"","pphy":"JIN, XIAO HONG MD","ppno":8047320648,"pcpadd":"15 GOODRICH AVE,","pcpcity":"PETERSBURG","pcpstate":"VA","pcpzip":"23805-9998","pcpcounty":"","pcpid":"","pcpname":"Cardiology of Virginia","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048616846,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["U07.1","N39.0","R09.81","R07.9","R06.02","M79.89","R53.83","Z86.16","F25.0","F90.2","F10.20","F41.1","F14.20","F31.30","F33.2","M25.561","T14.90XA","R69.","S39.012D","S16.1XXD","R29.3","M62.81","M54.5","M54.2","S39.012A","S16.1XXA","H65.01","J20.9","Z20.828","R60.0","K52.9","F17.200","R19.7","R10.13","M25.511","V87.7XXA","Y92.89","Y93.89","J30.81","K57.32","R05.9","R10.84","K62.5","R93.89","Z87.19","H60.91","H92.01","K29.90","R94.31","F43.10","R22.43","M79.604","F33.1","J18.9","R06.2","F31.11","B34.9","NO DATA","H02.9","K57.92","K92.2","R07.89","Z53.9","K50.90","F17.210","Z90.49","R10.30","J02.9","F31.89","F31.32","R10.9","R10.10","K21.9","K04.7","F20.9"],"date":["2022-05-25","2021-12-30","2021-12-30","2022-06-22","2022-06-23","2022-06-22","2022-06-22","2022-06-22","2022-11-22","2022-09-18","2022-12-05","2022-12-05","2022-12-05","2022-12-05","2023-06-01","2023-03-07","2021-05-19","2023-03-03","2021-07-01","2021-07-01","2021-06-29","2021-06-24","2021-07-27","2021-07-27","2021-07-27","2021-07-27","2021-04-26","2021-12-26","2021-12-26","2022-06-23","2022-11-10","2022-11-10","2023-05-24","2022-11-10","2021-05-19","2021-05-19","2021-05-19","2021-05-19","2021-09-14","2022-01-04","2022-01-04","2022-11-15","2022-11-15","2022-11-15","2023-01-27","2021-09-14","2021-09-14","2022-11-09","2022-06-22","2023-06-13","2023-03-07","2023-03-07","2022-09-04","2022-05-25","2022-05-25","2022-09-14","2023-03-12","2023-03-12","2023-03-12","2022-01-04","2022-01-04","2022-06-23","2023-01-27","2023-01-27","2023-01-27","2023-01-27","2023-01-27","2023-03-18","2023-05-19","2023-05-15","2023-05-24","2023-05-24","2023-05-24","2023-04-16","2023-06-13"],"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":[]},{"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":[["","57237002801","AMOXICILLIN","500 MG","30","Select","Select",""],["","00536129910","MECLIZINE","CHW 25MG","30","Select","Select",""],["","67877021560","CEFUROXIME","TAB 250MG","20","Select","Select",""],["","57237000511","FLUCONAZOLE","150 MG","2","Select","Select",""],["","72647033104","METHYLPRED","TAB 4MG","21","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","21","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","15","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","30","Select","Select",""],["","64380080807","IBUPROFEN","600 MG","20","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","30","Select","Select",""],["","00081067013","SUDAFED 12HR","TAB 120MG CR","20","Select","Select",""],["","69238161503","OFLOXACIN","DRO 0.3%OTIC","5","Select","Select",""],["","00054004641","IPRATROPIUM","SPR 0.0006","15","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","5","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","200","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","20","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","27241000550","RISPERIDONE","3 MG","30","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","43547028910","BUPROPION","TAB 150MG SR","60","Select","Select",""],["","00054429731","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","70954006020","PREDNISONE","20 MG","10","Select","Select",""],["","51224001060","BENZONATATE","CAP 100MG","15","Select","Select",""],["","62135098505","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","00121077504","GG\/CODEINE","SOL 100-10\/5","118","Select","Select",""],["","00093100301","BUSPIRONE","TAB 15MG","30","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","20","Select","Select",""],["","13107003105","MIRTAZAPINE","15 MG","30","Select","Select",""],["","70700015010","OMEPRAZOLE","20 MG","30","Select","Select",""],["","00591079501","DICYCLOMINE","TAB 20MG","7","Select","Select",""],["","81421002004","DULCOLAX","TAB 5MG EC","8","Select","Select",""],["","00781185220","AMOX\/K CLAV","TAB 875-125","14","Select","Select",""],["","65862022701","LAMOTRIGINE","25 MG","22","Select","Select",""],["","43547028910","BUPROPION HCL SR","150 MG","60","Select","Select",""],["","65862018730","ONDANSETRON HCL","4 MG","20","Select","Select",""],["","68462019005","NAPROXEN","500 MG","20","Select","Select",""],["","68180032002","BUPROPION XL","300 MG","30","Select","Select",""],["","65862016001","ZOLPIDEM TARTRATE","10 MG","30","Select","Select",""],["","70954002010","PRAZOSIN HCL","2 MG","11","Select","Select",""],["","58657050916","GUAIFENESIN","100 MG\/5ML","200","Select","Select",""],["","00378113401","KETOROLAC TROMETHAMINE","10 MG","12","Select","Select",""],["","11877001140","BINAXNOW COVID-","19 AG SELF TEST ","8","Select","Select",""],["","00536132701","ACETAMINOPHEN","325 MG","20","Select","Select",""],["","00781185220","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","20","Select","Select",""],["","00406012305","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","12","Select","Select",""],["","00143992801","CIPROFLOXACIN HCL","500 MG","20","Select","Select",""],["","65862018501","CLINDAMYCIN HCL","150 MG","90","Select","Select",""],["","50111033402","METRONIDAZOLE","500 MG","15","Select","Select",""],["","00143992801","CIPROFLOXACN TAB","500MG","14","Select","Select",""],["","50111033402","METRONIDAZOL TAB","500MG","20","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","57237000630","FLUCONAZOLE TAB","200MG","1","Select","Select",""],["","00093317431","ALBUTEROL AER HFA","","8","Select","Select",""],["","60432060416","PROMETHAZINE SYP DM","","200","Select","Select",""],["","51224001060","BENZONATATE CAP","100MG","15","Select","Select",""],["","00527293437","PREDNISONE TAB","20MG","21","Select","Select",""],["","00536129910","MECLIZINE CHW","25MG","30","Select","Select",""],["","00121077504","GG\/CODEINE SOL","100-10\/5","118","Select","Select",""],["","62135098505","DOXYCYCL HYC CAP","100MG","20","Select","Select",""],["","00054429731","FUROSEMIDE TAB","20MG","30","Select","Select",""],["","00781808926","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","72647033104","METHYLPRED TAB","4MG","21","Select","Select",""],["","43547028910","BUPROPION TAB","150MG SR","60","Select","Select",""],["","43547034250","RISPERIDONE TAB","2MG","30","Select","Select",""],["","13107003134","MIRTAZAPINE TAB","15MG","45","Select","Select",""],["","00172572860","FAMOTIDINE TAB","20MG","28","Select","Select",""],["","00093100301","BUSPIRONE TAB","15MG","30","Select","Select",""],["","00527128201","DICYCLOMINE TAB","20MG","7","Select","Select",""],["","57237007710","ONDANSETRON TAB","4MG ODT","5","Select","Select",""],["","70700015010","OMEPRAZOLE CAP","20MG","14","Select","Select",""],["","00781185220","AMOX\/K CLAV TAB","875-125","14","Select","Select",""],["","81421002004","DULCOLAX TAB","5MG EC","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":""}]}]}