{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHARLENA L BRENT","gend":1,"add":"3309 KING WILLIAM ROAD","city":"AYLETT","state":"VA","zip":"23009-9998","dob":"1982-09-09","age":"","mstatus":"","insh":"1558407*01","cliId":"","pno":2527517841,"cno":2527517841,"email":"","ename":"","eno":"","pphy":"BIGGERS, JONATHAN W DO","ppno":8047693022,"pcpadd":"11814 KING WILLIAM ROAD,","pcpcity":"AYLETT","pcpstate":"VA","pcpzip":"23009-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8047691253,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K50.118","R93.3","A41.9","K50.90","K52.9","D50.9","K50.10","R65.10","R07.89","K52.89","D53.9","R00.0","I51.7","R77.8","E27.40","Z12.11","I10.","F32.9","K21.9","D64.9","R10.9","F19.10","U07.1","F17.200","R53.1","Z91.19","N39.0","A41.50","F14.90","F14.10","R74.8","R07.9","L52.","K50.919","M25.562","D72.825","R50.9","Z68.1","R10.33","R10.84","Z74.3","R78.81","K50.119","B95.7","M79.661","M79.662","A41.51","F17.210","NO DATA","G89.29","M19.90","Z20.822","M25.462","N83.202","T38.0X5A","Z79.52","I35.1","I36.1","I37.1","I77.810","R79.89","D72.89","N89.8","M79.606","Z28.310","Z79.899","R06.89","R52.","I21.4","D72.829","R06.02","E87.1","R26.89","Z01.812","K50.911","B37.0","E27.2","L73.9","Z91.199"],"date":["2021-03-01","2021-03-01","2022-07-03","2022-09-11","2022-07-05","2022-10-19","2022-09-09","2022-06-29","2022-09-05","2022-07-04","2022-07-04","2022-10-17","2022-10-19","2022-10-17","2022-10-19","2021-03-01","2022-10-17","2021-03-01","2022-09-05","2023-08-13","2022-01-03","2023-08-13","2022-01-03","2022-10-17","2022-01-03","2022-06-30","2022-09-11","2022-09-07","2022-09-11","2022-09-08","2022-09-08","2022-09-08","2022-09-09","2022-10-19","2022-09-09","2022-09-09","2022-09-09","2022-09-09","2022-09-09","2022-10-19","2022-06-28","2022-07-01","2022-07-01","2022-07-01","2022-07-05","2022-07-05","2022-09-11","2022-09-05","2022-10-17","2022-09-05","2022-09-05","2022-10-17","2022-10-13","2022-09-05","2022-09-05","2022-10-17","2022-10-19","2022-09-07","2022-09-07","2022-09-07","2022-10-19","2022-10-19","2022-06-30","2022-06-30","2022-06-30","2022-06-30","2021-01-16","2023-08-13","2022-10-19","2022-10-19","2022-06-28","2021-01-16","2022-07-06","2021-02-25","2022-10-17","2022-10-17","2022-10-17","2022-10-17","2022-10-17"],"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":[["","57664049983","MIRTAZAPINE","15 MG","30","Select","Select",""],["","00228212810","CLONIDINE","TAB 0.2MG","60","Select","Select",""],["","52268001201","SUPREP BOWEL","SOL PREP KIT","354","Select","Select",""],["","00054458111","MERCAPTOPUR","TAB 50MG","30","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","Select","Select",""],["","00378064110","PREDNISONE","10 MG","60","Select","Select",""],["","00536100901","FERROUS SULF","TAB 325MG","30","Select","Select",""],["","13668009205","PRAMIPEXOLE","TAB 0.25MG","30","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","15","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","15","Select","Select",""],["","00093031101","LOPERAMIDE","CAP 2MG","20","Select","Select",""],["","00143312601","DICYCLOMINE","CAP 10MG","30","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","51672200306","CLOTRIMAZOLE","CRE 1% VAG","45","Select","Select",""],["","65862053820","LEVOFLOXACIN","TAB 750MG","2","Select","Select",""],["","70710113908","FLUCONAZOLE","150 MG","2","Select","Select",""],["","00536120215","LIDOCAINE PA","PAD 0.04","10","Select","Select",""],["","69842097417","DICLOFENAC","GEL 0.01","50","Select","Select",""],["","66689000816","NYSTATIN","100000\/ML","300","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","20","Select","Select",""],["","50428047392","CVS ALLERGY","CAP 25MG","20","Select","Select",""],["","00904723760","BANOPHEN","25 MG","30","Select","Select",""],["","63868025915","QC CLOTRIMAZ","CRE 0.01","45","Select","Select",""],["","76385011050","CARVEDILOL","TAB 3.125MG","60","Select","Select",""],["","00228212810","CLONIDINE HCL","0.2 MG","180","Select","Select",""],["","50428033020","ALLERGY RELIEF","25 MG","30","Select","Select",""],["","68180072103","AMLODIPINE BESYLATE","10 MG","30","Select","Select",""],["","50428047392","ALLERGY","25 MG","30","Select","Select",""],["","65862039010","ONDANSETRON TAB","4MG ODT","20","Select","Select",""],["","00093031101","LOPERAMIDE CAP","2MG","20","Select","Select",""],["","00603533815","PREDNISONE PAK","10MG","42","Select","Select",""],["","00378064205","PREDNISONE TAB","20MG","90","Select","Select",""],["","00143312601","DICYCLOMINE CAP","10MG","30","Select","Select",""],["","00054458111","MERCAPTOPUR TAB","50MG","30","Select","Select",""],["","00228212810","CLONIDINE TAB","0.2MG","180","Select","Select",""],["","51672200306","CLOTRIMAZOLE CRE","1% VAG","45","Select","Select",""],["","68180072103","AMLODIPINE TAB","10MG","30","Select","Select",""],["","50111033401","METRONIDAZOL TAB","500MG","4","Select","Select",""],["","63868025915","QC CLOTRIMAZ CRE","1%","45","Select","Select",""],["","70710113908","FLUCONAZOLE TAB","150MG","1","Select","Select",""],["","00536120215","LIDOCAINE PA PAD","4%","10","Select","Select",""],["","50428047392","CVS ALLERGY CAP","25MG","20","Select","Select",""],["","65862053820","LEVOFLOXACIN TAB","750MG","2","Select","Select",""],["","76385011050","CARVEDILOL TAB","3.125MG","60","Select","Select",""],["","66689000816","NYSTATIN SUS","100000","160","Select","Select",""],["","42858010201","OXYCOD\/APAP TAB","5-325MG","10","Select","Select",""],["","65162019050","NAPROXEN TAB","500MG","20","Select","Select",""],["","69842097417","DICLOFENAC GEL","1%","50","Select","Select",""],["","00904723760","BANOPHEN CAP","25MG","30","Select","Select",""],["","57664049983","MIRTAZAPINE TAB","15MG","90","Select","Select",""],["","50111033401","METRONIDAZOLE","500 MG","14","Select","Select",""],["","49483034150","ACETAMINOPHEN","500 MG","30","Select","Select",""],["","69097052444","DICLOFENAC SODIUM","1 %","100","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":""}]}]}