{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TYRONE C RICHARDSON","gend":0,"add":"3363 DILL AVE","city":"RICHMOND","state":"VA","zip":"23222-9998","dob":"1971-06-19","age":"","mstatus":"","insh":"1656241*01","cliId":"","pno":8043030086,"cno":8043030086,"email":"","ename":"","eno":"","pphy":"MORGAN, JOHN W MD","ppno":8048289357,"pcpadd":"417 N 11TH ST,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23293-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048287591,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N17.9","N12.","A41.50","N39.0","N10.","R65.20","N17.8","R73.9","E83.42","F10.99","R31.9","R50.81","I10.","F17.210","F10.10","A41.51","R13.10","E87.8","Z71.89","E11.9","NO DATA","K21.9","Z20.822","M10.9","Z72.89","Z79.84","R80.9","Z72.0"],"date":["2022-02-19","2022-03-08","2022-02-17","2022-02-17","2022-02-17","2022-02-18","2022-02-17","2022-02-17","2022-02-17","2022-02-17","2022-02-17","2022-02-17","2023-05-26","2022-02-17","2022-02-18","2022-02-18","2022-02-18","2022-02-18","2022-04-05","2023-05-26","2022-03-08","2022-03-08","2022-02-17","2023-05-26","2022-02-17","2022-02-17","2023-05-26","2023-05-26"],"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":[["","55111012305","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","00378718505","METFORMIN","TAB 500MG","180","Select","Select",""],["","00904053961","THERA","TAB ","30","Select","Select",""],["","31722072250","LEVOFLOXACIN","TAB 500MG","18","Select","Select",""],["","11534016503","FOLIC ACID","TAB 1MG","30","Select","Select",""],["","53885024450","ONETOUCH","TES ULTRA","50","Select","Select",""],["","65862078430","ESOMEPRA MAG","CAP 40MG DR","30","Select","Select",""],["","68180051202","LISINOPRIL","2.5 MG","90","Select","Select",""],["","31604001281","B1","TAB 100MG","30","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","20","Select","Select",""],["","65862018501","CLINDAMYCIN","CAP 150MG","28","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","200","Select","Select",""],["","43598083205","ATORVASTATIN CALCIUM","40 MG","90","Select","Select",""],["","70010049105","METFORMIN HCL ER","500 MG","60","Select","Select",""],["","29300034901","ALLOPURINOL","100 MG","30","Select","Select",""],["","11534016503","FOLIC ACID TAB","1MG","30","Select","Select",""],["","43598083205","ATORVASTATIN TAB","40MG","30","Select","Select",""],["","70010049105","METFORMIN TAB","500MG ER","60","Select","Select",""],["","00904053961","THERA TAB","","30","Select","Select",""],["","31722072250","LEVOFLOXACIN TAB","500MG","18","Select","Select",""],["","68180051202","LISINOPRIL TAB","2.5MG","30","Select","Select",""],["","53885024450","ONETOUCH TES ULTRA","","50","Select","Select",""],["","65862078430","ESOMEPRA MAG CAP","40MG DR","30","Select","Select",""],["","53885004601","ONETOUCH KIT ULTRA","2","1","Select","Select",""],["","65862018501","CLINDAMYCIN CAP","150MG","28","Select","Select",""],["","00406048410","APAP\/CODEINE TAB","300-30MG","20","Select","Select",""],["","31604001281","B","1 TAB 100MG","30","Select","Select",""],["","53885000810","ONETOUCH DEL MIS PLUS","33G","200","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":""}]}]}