{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CALVIN L BARNER","gend":0,"add":"1117 HINTON ST","city":"PETERSBURG","state":"VA","zip":"23803-9998","dob":"1987-11-04","age":"","mstatus":"","insh":"20023603*01","cliId":"","pno":8047336429,"cno":8047336429,"email":"","ename":"","eno":"","pphy":"BUSH, JAMES MD","ppno":8045201110,"pcpadd":"3512 BOULEVARD,","pcpcity":"COLONIAL HEIGHTS","pcpstate":"VA","pcpzip":"23834-9998","pcpcounty":"","pcpid":"","pcpname":"Appomattox River Primary Care, LLC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8045263105,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Q82.8","B35.3","B35.1","M79.674","M79.89","J45.909","Z23.","F17.200","A52.8","E78.2","J45.20","F17.210","L20.9","A53.9","Q62.5","F33.2","H60.92","H92.02","F33.0","F32.2","F33.1","H40.003","L60.0","Q63.9","M54.5","G89.29","Z68.37","H60.502","E78.5","R68.89","Z20.822","Z11.3","H00.14","H10.423","L02.31","NO DATA","H00.021","K65.1","R10.32","F33.42","L98.9","F31.9","F32.9"],"date":["2022-10-18","2023-08-15","2023-08-15","2021-09-21","2021-09-21","2023-05-12","2021-09-21","2023-05-12","2021-12-30","2022-06-15","2023-06-14","2022-06-15","2022-12-14","2022-01-07","2022-06-15","2022-11-23","2022-10-10","2022-10-10","2022-12-18","2023-09-17","2023-09-13","2023-08-14","2023-08-15","2021-03-24","2021-03-24","2021-03-24","2021-03-24","2022-12-14","2023-06-14","2022-12-14","2022-12-14","2023-06-14","2021-11-19","2021-10-29","2023-05-12","2023-05-12","2021-05-03","2021-06-21","2023-05-12","2023-06-13","2021-07-13","2022-01-23","2022-03-11"],"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":[["","68180035302","SERTRALINE","TAB 100MG","45","Select","Select",""],["","60505265401","TRAZODONE","TAB 100MG","60","Select","Select",""],["","68462018117","CLOTRIMAZOLE","CRE 0.01","60","Select","Select",""],["","68180031909","BUPROPN HCL","TAB 150MG XL","30","Select","Select",""],["","59267102501","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","76204020025","ALBUTEROL","NEB 0.00083","300","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","70461032203","FLUCLVX QUAD","INJ 2022-23","0","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00781618667","CIPRO\/DEXA","SUS 0.3-0.1%","8","Select","Select",""],["","68180031909","BUPROPION XL","150 MG","30","Select","Select",""],["","76204020025","ALBUTEROL SULFATE","2.5 MG\/3ML","300","Select","Select",""],["","60505265401","TRAZODONE HCL","100 MG","20","Select","Select",""],["","00116200116","CHLORHEXIDINE GLUCONATE","0.12 %","473","Select","Select",""],["","65862050320","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","10","Select","Select",""],["","57237002801","AMOXICILLIN","500 MG","21","Select","Select",""],["","64380080707","IBUPROFEN","800 MG","15","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":""}]}]}