{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANTONIO M JONES","gend":0,"add":"C\/O MPU 1126062 6900 ATMORE DR","city":"RICHMOND","state":"VA","zip":"23225-9998","dob":"1978-03-08","age":"","mstatus":"","insh":"1605842*01","cliId":"","pno":4342226876,"cno":4342226876,"email":"","ename":"","eno":"","pphy":"TRIEU, DUC K MD","ppno":4345728921,"pcpadd":"1020 BILL TUCK HWY STE 900,","pcpcity":"SOUTH BOSTON","pcpstate":"VA","pcpzip":"24592-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4345751290,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["T18.128A","K85.90","R11.2","K76.0","R10.84","K21.9","NO DATA","J44.9","E11.65","I11.9","I10.","Z98.890","Z87.19","R20.2","E11.40","F31.9","Z88.0","Z88.8","Z88.1","Z91.030","Z79.84","F17.210","Z79.899","G51.0","E66.9","R07.2","F25.1","K64.1","G47.33","K85.30","N28.89","R16.0","E78.5","E07.9","T46.4X5A","Z20.822","Z79.82","R11.0","R33.9","D41.01","R33.8","R10.9","S00.412A","Z74.3","R07.89","R19.7","Z91.19","R07.9","K64.9","J43.9","G47.10","S00.03XA","Z01.818","E11.9","Z88.2","Z91.014","Z51.81","T18.108A","F17.290","J45.40","G62.9","E66.01","K29.90","K44.9","B37.81","K29.70","F52.21","R05.","Z20.828","V58.89","F41.1","K64.8","R10.11","Z91.018","Z86.010","N28.1","R21.","F32.1","Z82.3","Z82.49","Z91.048","R58.","J45.31","J42.","Z91.013","R10.2","Z91.02","N20.0","M79.5","L29.9","Z68.36","R25.2","E11.8"],"date":["2021-02-07","2021-03-25","2022-04-11","2022-07-15","2022-07-15","2022-11-04","2021-04-19","2023-04-04","2022-01-26","2021-04-19","2023-01-29","2021-04-19","2021-05-10","2021-12-03","2023-04-07","2022-07-28","2023-01-29","2021-11-12","2022-12-29","2023-01-29","2023-04-07","2023-04-07","2021-11-12","2021-12-03","2023-03-25","2022-06-26","2023-08-24","2021-04-13","2023-05-08","2021-02-20","2021-02-20","2021-02-20","2021-02-20","2021-02-20","2021-02-20","2021-09-02","2021-08-08","2021-02-20","2021-04-14","2022-07-15","2021-05-19","2021-05-19","2021-08-08","2021-08-08","2023-01-29","2022-04-11","2022-04-11","2023-01-29","2022-07-28","2022-12-29","2022-12-29","2021-08-08","2022-07-21","2023-01-29","2023-01-29","2022-09-25","2022-10-18","2021-02-07","2023-04-04","2021-02-23","2022-01-26","2022-01-26","2021-02-07","2021-02-23","2021-02-23","2021-02-23","2021-11-15","2021-08-25","2021-08-25","2021-03-19","2023-02-24","2021-05-10","2021-05-10","2023-03-25","2022-07-28","2022-07-15","2023-03-25","2021-08-13","2022-07-28","2023-01-29","2022-07-28","2022-07-28","2022-11-04","2022-11-04","2023-01-29","2021-04-14","2021-04-14","2022-07-15","2022-07-15","2023-03-25","2023-03-25","2023-04-07","2023-04-07"],"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":[["","68645055654","LISINOP\/HCTZ","TAB 10-12.5","90","Select","Select",""],["","43547028111","ESCITALOPRAM","TAB 10MG","180","Select","Select",""],["","45963014205","BUPROPN HCL","TAB 300MG XL","30","Select","Select",""],["","68180051701","LISINOPRIL","TAB 40MG","90","Select","Select",""],["","47335001183","TADALAFIL","TAB 10MG","30","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","68462010230","FLUCONAZOLE","TAB 100MG","21","Select","Select",""],["","16729014801","QUETIAPINE","TAB 200MG","60","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","23155000210","HYDRALAZINE","TAB 25MG","30","Select","Select",""],["","45802020625","NICOTINE POL","GUM 2MG MINT","110","Select","Select",""],["","65162010211","GABAPENTIN","CAP 300MG","60","Select","Select",""],["","47781063730","BUPROPION","TAB 450MG XL","30","Select","Select",""],["","00173071920","FLOVENT HFA","AER 110MCG","12","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00173086910","ANORO ELLIPT","AER 62.5-25","60","Select","Select",""],["","68645051554","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","59746033990","LOSARTAN\/HCT","TAB 100-25","90","Select","Select",""],["","00904699880","DOCUSATE SOD","CAP 100MG","30","Select","Select",""],["","52817036100","METOPROL TAR","TAB 50MG","60","Select","Select",""],["","00173089310","TRELEGY","AER ELLIPTA","60","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","18","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","18","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","12843003520","STOOL SOFTNR","CAP 100MG","30","Select","Select",""],["","00603188016","LIDOCAINE","5 %","20","Select","Select",""],["","45802086866","POLYETH GLYC","POW 3350 NF","14","Select","Select",""],["","69367024312","HYDROCORT AC","SUP 25MG","12","Select","Select",""],["","49502050002","EPIPEN 2-PAK","INJ 0.3MG","2","Select","Select",""],["","00904555159","BANOPHEN","TAB 25MG","24","Select","Select",""],["","13107003205","MIRTAZAPINE","TAB 45MG","90","Select","Select",""],["","00115169449","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","45802004935","TRIAMCINOLON","OIN 0.005","45","Select","Select",""],["","62559043130","HYDROCORTISO","CRE 0.025","30","Select","Select",""],["","69315031228","PROCTO-MED","CRE HC 2.5%","28","Select","Select",""],["","67877041301","METFORMIN","TAB 500MG ER","360","Select","Select",""],["","57237004330","VALACYCLOVIR","TAB 1GM","10","Select","Select",""],["","59762444002","METHYLPRED","TAB 4MG","21","Select","Select",""],["","16729017217","AMITRIPTYLIN","TAB 25MG","30","Select","Select",""],["","57237001999","DULOXETINE","CAP 60MG","30","Select","Select",""],["","43547036211","LOSARTAN POT","TAB 100MG","30","Select","Select",""],["","68645059459","FAMOTIDINE","TAB 20MG","28","Select","Select",""],["","16729018317","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","00713050324","ANUCORT-HC","SUP 25MG","12","Select","Select",""],["","63739019861","PEG 3350","POW ","12","Select","Select",""],["","16714020030","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","68382003510","VENLAFAXINE","CAP 75MG ER","30","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","41100080676","MIRALAX","POW 3350 NF","10","Select","Select",""],["","50383066730","LIDO\/PRILOCN","CRE 2.5-2.5%","30","Select","Select",""],["","13107008501","LORAZEPAM","2 MG","14","Select","Select",""],["","29300024505","BUSPIRONE","TAB 10MG","60","Select","Select",""],["","71921016201","DOXEPIN HCL","CAP 10MG","30","Select","Select",""],["","68180096301","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","43547036211","LOSARTAN POTASSIUM","100 MG","30","Select","Select",""],["","68382003610","VENLAFAXINE HCL ER","150 MG","30","Select","Select",""],["","23155050110","HYDROXYZINE HCL","25 MG","15","Select","Select",""],["","00093083205","CLONAZEPAM","0.5 MG","30","Select","Select",""],["","29300024705","BUSPIRONE HCL","30 MG","60","Select","Select",""],["","57237010199","METOPROLOL TARTRATE","50 MG","60","Select","Select",""],["","45802011222","MUPIROCIN","2 %","22","Select","Select",""],["","00054981729","PREDNISONE","10 MG","26","Select","Select",""],["","00555015904","CHLORDIAZEPOXIDE HCL","25 MG","60","Select","Select",""],["","65862056099","PANTOPRAZOLE TAB","40MG","30","Select","Select",""],["","57237001999","DULOXETINE CAP","60MG","30","Select","Select",""],["","65862052305","GABAPENTIN TAB","600MG","90","Select","Select",""],["","45963014205","BUPROPN HCL TAB","300MG XL","30","Select","Select",""],["","68645051554","AMLODIPINE TAB","5MG","90","Select","Select",""],["","00904693176","PEG","3350 POW","12","Select","Select",""],["","16714020030","ONDANSETRON TAB","4MG ODT","12","Select","Select",""],["","65162010211","GABAPENTIN CAP","300MG","60","Select","Select",""],["","43547036211","LOSARTAN POT TAB","100MG","30","Select","Select",""],["","16729018317","HYDROCHLOROT TAB","25MG","30","Select","Select",""],["","52817036100","METOPROL TAR TAB","50MG","60","Select","Select",""],["","16729014801","QUETIAPINE TAB","200MG","60","Select","Select",""],["","00904699880","DOCUSATE SOD CAP","100MG","30","Select","Select",""],["","68645059459","FAMOTIDINE TAB","20MG","28","Select","Select",""],["","00713050324","ANUCORT-HC SUP","25MG","12","Select","Select",""],["","59746033990","LOSARTAN\/HCT TAB","100-25","90","Select","Select",""],["","12843003520","STOOL SOFTNR CAP","100MG","30","Select","Select",""],["","67877041301","METFORMIN TAB","500MG ER","360","Select","Select",""],["","53746010901","HYDROCO\/APAP TAB","5-325MG","18","Select","Select",""],["","41100080676","MIRALAX POW","3350 NF","10","Select","Select",""],["","68382003610","VENLAFAXINE CAP","150MG ER","30","Select","Select",""],["","00093031401","KETOROLAC TAB","10MG","20","Select","Select",""],["","16729017217","AMITRIPTYLIN TAB","25MG","30","Select","Select",""],["","69315031228","PROCTO-MED CRE HC","2.5%","28","Select","Select",""],["","50383066730","LIDO\/PRILOCN CRE","2.5-2.5%","30","Select","Select",""],["","71921016201","DOXEPIN HCL CAP","10MG","30","Select","Select",""],["","13107008501","LORAZEPAM TAB","2MG","14","Select","Select",""],["","29300024505","BUSPIRONE TAB","10MG","60","Select","Select",""],["","68382080510","TRAZODONE HCL","50 MG","30","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":""}]}]}