{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"COURTNEY  M WRENN","gend":1,"add":"630 MAIN ST APT B","city":"SMITHFIELD","state":"VA","zip":"23430-9998","dob":"1983-02-25","age":"","mstatus":"","insh":"1372722*01","cliId":"","pno":7573714779,"cno":7573714779,"email":"","ename":"","eno":"","pphy":"STEVENSON, MICHAEL G PA","ppno":7573573331,"pcpadd":"201 GUMWOOD DRIVE","pcpcity":"SMITHFIELD","pcpstate":"VA","pcpzip":"23430-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7573569711,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.42","E11.43","Z79.4","E03.9","I10.","E55.9","E66.9","E11.9","M25.572","M24.572","M21.6X1","M21.6X2","E10.9","E11.65","Z01.818","R10.2","N92.4","G47.33","L60.3","Z23.","N30.00","R10.31","D50.8","G89.29","M53.88","M46.1","M47.896","N39.0","Z68.34","NO DATA","M96.1","F43.8","G89.4","M20.5X1","M20.11","M20.12","Z45.89","N92.6","Z68.41","N60.21","Z79.84","H11.153","H25.13","H04.123","G57.82","M54.32","M35.1","Z68.32","Z98.84","Z96.41","Z88.6","R11.0","E78.5","B35.4","M62.81","M25.522","M25.521","T78.40XA","M77.12","Z01.812","Z32.02","M51.36","Z20.822","N63.14","Z01.411","B96.89","R23.4","Z68.33","M99.04","S90.112A","N92.0","D48.61","Z72.51"],"date":["2022-10-05","2023-04-17","2023-04-17","2023-04-17","2023-04-17","2023-04-17","2023-04-17","2022-12-29","2022-12-16","2022-12-16","2022-12-16","2022-12-16","2023-02-07","2023-04-07","2021-07-08","2021-10-21","2021-07-16","2021-07-16","2021-09-14","2022-09-19","2021-10-21","2021-10-21","2022-11-29","2022-10-11","2021-12-02","2022-06-20","2022-10-11","2022-06-07","2022-08-03","2022-10-11","2022-10-11","2022-07-20","2022-07-20","2021-02-09","2022-12-29","2022-12-29","2021-02-16","2021-07-08","2021-07-08","2021-08-31","2022-02-02","2022-02-02","2022-02-02","2022-02-02","2022-08-05","2022-08-05","2023-01-03","2023-01-03","2022-04-07","2021-10-21","2021-10-21","2021-10-21","2022-07-18","2022-08-03","2022-09-01","2022-09-01","2022-09-01","2021-02-16","2021-04-27","2021-05-05","2021-05-05","2021-10-05","2021-04-21","2021-07-28","2022-04-04","2022-04-04","2021-04-26","2021-04-26","2022-07-28","2022-12-16","2023-01-23","2021-08-31","2022-12-01"],"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":[["","00002773701","INSULIN LISP","INJ 100\/ML","60","Select","Select",""],["","65862042001","SMZ\/TMP DS","TAB 800-160","14","Select","Select",""],["","50111056003","TRAZODONE","TAB 50MG","30","Select","Select",""],["","57237021990","PIOGLITAZONE","TAB 15MG","30","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","60","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","10","Select","Select",""],["","00527293437","PREDNISONE","TAB 20MG","10","Select","Select",""],["","57237000511","FLUCONAZOLE","150 MG","3","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","12","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","00597015330","JARDIANCE","25 MG","90","Select","Select",""],["","61442010305","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","59762444002","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00115164501","NITROFUR MAC","CAP 100MG","21","Select","Select",""],["","00169406012","VICTOZA","INJ 18MG\/3ML","6","Select","Select",""],["","49884072703","DOXYCYC MONO","CAP 100MG","14","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","31722053401","METHOCARBAM","TAB 750MG","90","Select","Select",""],["","00143992950","CIPROFLOXACN","TAB 750MG","14","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","60","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","33342032915","TRIAMCINOLON","CRE 0.001","15","Select","Select",""],["","45802005935","NYSTATIN","CRE 100000","15","Select","Select",""],["","21922002505","KETOCONAZOLE","CRE 0.02","30","Select","Select",""],["","00169413013","OZEMPIC","1\/0.75 (3)","3","Select","Select",""],["","62088000031","INPEN 100EL","MIS BLUE-HUM","2","Select","Select",""],["","51672130406","TERCONAZOLE","CRE 0.004","45","Select","Select",""],["","57664037708","TRAMADOL HCL","50 MG","28","Select","Select",""],["","65862037501","ESCITALOPRAM OXALATE","20 MG","30","Select","Select",""],["","00002143380","TRULICITY","0.75MG\/0.5","6","Select","Select",""],["","55111017915","TIZANIDINE HCL","2 MG","30","Select","Select",""],["","65862051230","PIOGLITAZONE HCL","15 MG","90","Select","Select",""],["","00002751001","HUMALOG","100\/ML","90","Select","Select",""],["","08290328438","INSULIN SYRINGE","31 GX5\/16\"","100","Select","Select",""],["","50111056001","TRAZODONE HCL","50 MG","30","Select","Select",""],["","00168000615","TRIAMCINOLONE ACETONIDE","0.1 %","30","Select","Select",""],["","00642746605","NUVESSA","1.3 %","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":""}]}]}