{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PATRICIA A EDWARDS","gend":1,"add":"11101 COBBS ROAD","city":"GLEN ALLEN","state":"VA","zip":"23059-9998","dob":"1967-05-16","age":"","mstatus":"","insh":"20026905*01","cliId":"","pno":8043078415,"cno":8043078415,"email":"","ename":"","eno":"","pphy":"ALI, SABINA MD","ppno":8046732814,"pcpadd":"5855 BREMO ROAD STE 102,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23226-9998","pcpcounty":"","pcpid":"","pcpname":"Monument Internal Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8046732873,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.31","M47.817","R20.1","M54.32","I44.4","N39.46","N32.81","N36.43","NO DATA","M51.26","J30.1","J06.9","M54.6","R10.13","I10.","E11.9","Z79.84","Z20.822","F43.12","F33.1","F14.21","E78.2","M50.20","E66.01","Z68.43","Z01.419","R39.14","Z21.","R76.8","E11.40","F14.23","E55.9","F14.24","B37.2","B20.","Z23.","Z68.42","M47.26","H90.42","H93.13","L21.9","H90.3","M79.661","R07.9","H25.13","H01.011","H01.014","R07.89","R06.02","Z12.4","M25.561","M25.562","G89.29","M79.604","R07.2"],"date":["2021-01-29","2021-01-29","2021-01-06","2021-08-31","2022-11-18","2021-08-05","2021-08-05","2021-08-05","2021-01-29","2021-01-29","2021-10-26","2021-10-26","2022-11-18","2022-11-18","2023-09-20","2023-09-20","2023-07-31","2022-11-18","2021-01-02","2021-01-02","2021-01-02","2023-09-20","2021-06-08","2022-03-10","2021-06-08","2021-07-06","2021-07-06","2023-09-20","2021-08-31","2021-08-31","2021-08-31","2023-07-31","2021-08-31","2022-09-08","2022-09-08","2022-09-08","2023-09-20","2022-03-10","2023-05-18","2023-05-18","2023-05-18","2023-05-18","2023-08-22","2023-08-25","2023-08-15","2023-08-15","2023-08-15","2023-08-22","2023-09-20","2023-07-31","2023-07-31","2023-07-31","2023-07-31","2023-08-22","2023-09-20"],"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":[["","50458014130","INVOKANA","300 MG","30","Select","Select",""],["","70377002811","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","45","Select","Select",""],["","00597014030","TRADJENTA","5 MG","30","Select","Select",""],["","69097067805","PREGABALIN","CAP 50MG","60","Select","Select",""],["","67877056110","METFORMIN","TAB 500MG","120","Select","Select",""],["","30768019941","VITAMIN D3","CAP 50MCG","30","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","61958250101","BIKTARVY","50-200-25","30","Select","Select",""],["","00469260130","MYRBETRIQ","TAB 25MG","30","Select","Select",""],["","60432026415","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","23900001443","VICK DAYQUIL","CAP COLD\/FLU","24","Select","Select",""],["","69097015915","MELOXICAM","TAB 15MG","30","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","30","Select","Select",""],["","62559099212","FLUCONAZOLE","TAB 150MG","3","Select","Select",""],["","58160081912","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","51672128902","NYSTATIN","CRE 100000","30","Select","Select",""],["","00093342210","CYCLOBENZAPR","TAB 10MG","20","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","15","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","5","Select","Select",""],["","53885027210","ONETOUCH VERIO TEST STRIP","","200","Select","Select",""],["","53885000810","ONETOUCH DELICA PLUS LANCET","33 GAUGE","100","Select","Select",""],["","70377002811","ATORVASTATIN CALCIUM","20 MG","30","Select","Select",""],["","67877056110","METFORMIN HCL","500 MG","120","Select","Select",""],["","53885092701","ONETOUCH VERIO REFLECT METER","","1","Select","Select",""],["","65702061710","ACCU-CHEK GUIDE MONITOR SYSTEM","","1","Select","Select",""],["","00228282011","HYDROCHLOROTHIAZIDE","12.5 MG","30","Select","Select",""],["","65702071110","ACCU-CHEK GUIDE TEST STRIP","","200","Select","Select",""],["","00002223680","TRULICITY","3 MG\/0.5ML","4","Select","Select",""],["","00597014030","TRADJENTA TAB","5MG","30","Select","Select",""],["","70377002811","ATORVASTATIN TAB","20MG","30","Select","Select",""],["","50458014130","INVOKANA TAB","300MG","30","Select","Select",""],["","67877056110","METFORMIN TAB","500MG","120","Select","Select",""],["","00536135301","VITAMIN D","3 CAP 50MCG","30","Select","Select",""],["","61958250101","BIKTARVY TAB","","30","Select","Select",""],["","69097015915","MELOXICAM TAB","15MG","30","Select","Select",""],["","51672128902","NYSTATIN CRE","100000","30","Select","Select",""],["","62559099212","FLUCONAZOLE TAB","150MG","3","Select","Select",""],["","58160081912","SHINGRIX INJ","50\/0.5ML","1","Select","Select",""],["","16729018201","HYDROCHLOROT TAB","12.5MG","30","Select","Select",""],["","49483060450","IBUPROFEN TAB","800MG","15","Select","Select",""],["","10702001801","OXYCODONE TAB","5MG","5","Select","Select",""],["","00093342210","CYCLOBENZAPR TAB","10MG","20","Select","Select",""],["","68462026390","ROSUVASTATIN CALCIUM","20 MG","90","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":""}]}]}