{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CIERRA  R GRAY","gend":1,"add":"1204 LOUIS LN APT B","city":"HOPEWELL","state":"VA","zip":"23860-9998","dob":"1990-07-20","age":"","mstatus":"","insh":"1650345*01","cliId":"","pno":8044410168,"cno":8044410168,"email":"","ename":"","eno":"","pphy":"SHAH, AMAR MD","ppno":8042568282,"pcpadd":"7300 ASHLAKE PKWY STE 200","pcpcity":"CHESTERFIELD","pcpstate":"VA","pcpzip":"23832-9998","pcpcounty":"","pcpid":"","pcpname":"VitalCare Family, LLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8042568288,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z20.822","I10.","R51.9","L73.2","L02.411","F17.210","E66.01","Z68.38","L90.5","R20.8","E66.9","F33.2","F51.01","F41.1","F31.76","N39.0","R11.2","R10.84","F31.9","E55.9","F17.200","K21.9","R00.2","I83.813","F33.1","F43.10","J30.2","R06.2","R09.81","R06.02","J45.909"],"date":["2021-08-02","2022-05-16","2021-09-15","2022-02-09","2021-11-17","2021-12-15","2022-05-28","2021-12-15","2022-02-09","2022-02-09","2022-02-09","2023-04-06","2023-04-06","2023-04-06","2023-04-06","2021-09-15","2021-09-15","2022-05-28","2022-05-28","2022-05-28","2022-05-16","2021-09-15","2022-05-16","2022-05-16","2023-02-02","2023-02-02","2021-04-13","2021-04-13","2021-04-13","2021-04-13","2021-04-13"],"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":[["","43547042309","LOSARTAN\/HCT","TAB 50-12.5","30","Select","Select",""],["","00406324301","HYDROMORPHON","TAB 2MG","21","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","60","Select","Select",""],["","23155014201","DOXYCYCL HYC","TAB 100MG DR","30","Select","Select",""],["","16729020001","BUSPIRONE","TAB 5MG","30","Select","Select",""],["","10702005601","OXYCODONE","TAB 10MG","28","Select","Select",""],["","49884072703","DOXYCYC MONO","CAP 100MG","20","Select","Select",""],["","69452015120","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","00363089588","NICOTINE TD","DIS 14MG\/24H","28","Select","Select",""],["","57664049983","MIRTAZAPINE","TAB 15MG","14","Select","Select",""],["","00781107905","ALPRAZOLAM","1 MG","28","Select","Select",""],["","51552086506","JESSNERS","SOL ","473","Select","Select",""],["","71093011105","GABAPENTIN","600 MG","120","Select","Select",""],["","67877043003","ARIPIPRAZOLE","TAB 2MG","30","Select","Select",""],["","68462013901","OXCARBAZEPIN","TAB 600MG","180","Select","Select",""],["","00536113920","PAIN RELIEF","CRE 0.04","15","Select","Select",""],["","00378632577","VALSART\/HCTZ","TAB 320-25MG","180","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","00074012402","HUMIRA PEN","INJ 80\/0.8ML","2","Select","Select",""],["","70710113908","FLUCONAZOLE","150 MG","2","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","15","Select","Select",""],["","10702002601","PHENTERMINE","CAP 15MG","30","Select","Select",""],["","00228277811","PROPRANOLOL","CAP 60MG ER","30","Select","Select",""],["","00832054011","BUMETANIDE","0.5 MG","90","Select","Select",""],["","59651017301","DOXEPIN HCL","10 MG","30","Select","Select",""],["","00536126720","LIDOCAINE","CRE 0.04","60","Select","Select",""],["","68180035202","SERTRALINE","TAB 50MG","60","Select","Select",""],["","00069108530","PAXLOVID","TAB 300-100","30","Select","Select",""],["","00093216568","NALOXONE HCL","SPR 4MG","2","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","60","Select","Select",""],["","68180067006","LURASIDONE HCL","20 MG","30","Select","Select",""],["","51991081701","PROPRANOLOL HCL ER","60 MG","90","Select","Select",""],["","72060014230","CAPLYTA","42 MG","30","Select","Select",""],["","00074012402","HUMIRA(CF) PEN","80MG\/0.8ML","2","Select","Select",""],["","00074012403","HUMIRA(CF) PEN CROHN'S-UC-HS","80MG\/0.8ML","3","Select","Select",""],["","63402030230","LATUDA","20 MG","30","Select","Select",""],["","42806016005","HYDROXYZINE HCL","25 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":""}]}]}