{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARQUET L GOODE","gend":0,"add":"1703 HUNGARY RD APT 8","city":"HENRICO","state":"VA","zip":"23228-9998","dob":"1991-04-19","age":"","mstatus":"","insh":"20027995*01","cliId":"","pno":4345322699,"cno":4345322699,"email":"","ename":"","eno":"","pphy":"GIUNTA, SUZANNE M MD","ppno":8042307777,"pcpadd":"4730 N SOUTHSIDE PLAZA,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23224-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8042302071,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R41.82","R45.5","F10.929","M54.5","V87.7XXA","NO DATA","J06.9","J30.9","Z76.0","M25.572","S93.402A","B37.0","F10.20","Z11.3","H61.22","J45.20","J96.90","F10.129","R45.1","Z99.11","J45.909","F32.9","Y90.8","J02.9","Z20.822","J34.89","J45.40","F81.9","Z72.51","R00.0","J96.01","T42.4X5A","Z91.040","Z87.891","Z79.51","A64.","R30.0","F41.9","V79.50XA","R06.02","S86.012A","M25.472","Y93.67","R50.9","N34.2","Z11.4","M76.62","J39.2"],"date":["2021-04-02","2021-04-02","2021-04-02","2021-08-23","2021-08-23","2023-07-12","2021-12-02","2021-12-02","2021-12-02","2022-04-25","2023-07-12","2022-06-30","2023-07-12","2023-07-12","2023-07-12","2023-07-12","2021-04-02","2021-04-03","2021-04-02","2021-04-02","2021-04-02","2021-04-02","2021-04-02","2022-01-03","2022-01-03","2022-01-03","2022-03-14","2022-03-14","2023-01-10","2021-04-03","2021-04-02","2021-04-02","2021-04-02","2021-04-02","2021-04-02","2022-11-14","2022-11-14","2021-04-03","2021-08-23","2021-04-03","2022-04-25","2022-04-25","2022-04-25","2022-01-03","2022-03-31","2022-03-31","2022-06-21","2022-06-21"],"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":[["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59310057922","PROAIR HFA","AER ","18","Select","Select",""],["","00378623201","CITALOPRAM","TAB 20MG","30","Select","Select",""],["","45802065078","LORATADINE","10 MG","90","Select","Select",""],["","00173071820","FLOVENT HFA","44 MCG","10.6","Select","Select",""],["","67877032101","IBUPROFEN","800 MG","100","Select","Select",""],["","42037010478","DEBROX","SOL 6.5% OT","15","Select","Select",""],["","00536117201","ACETAMIN","TAB 500MG","30","Select","Select",""],["","60432053716","NYSTATIN","100000\/ML","280","Select","Select",""],["","00406117003","NALTREXONE","TAB 50MG","30","Select","Select",""],["","70000049001","EARWAX","SOL REMOVAL","15","Select","Select",""],["","00904662735","EAR DROPS","DRO 0.065","15","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","55111078401","FEXOFENADINE","TAB 180MG","30","Select","Select",""],["","50428038612","ACETAMINOPHN","TAB 500MG","30","Select","Select",""],["","42806031250","DOXYCYCL HYC","TAB 100MG","14","Select","Select",""],["","60505082901","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","13668001005","CITALOPRAM HBR","20 MG","90","Select","Select",""],["","00406117003","NALTREXONE HCL","50 MG","60","Select","Select",""],["","78112073621","MURINE EAR WAX REMOVAL SYSTEM","6.5 %","15","Select","Select",""],["","00781808926","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","00378623201","CITALOPRAM TAB","20MG","90","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","42037010478","DEBROX SOL","6.5% OT","15","Select","Select",""],["","45802065078","LORATADINE TAB","10MG","30","Select","Select",""],["","64380080707","IBUPROFEN TAB","800MG","100","Select","Select",""],["","00173071820","FLOVENT HFA AER","44MCG","11","Select","Select",""],["","66689000816","NYSTATIN SUS","100000","280","Select","Select",""],["","00904662735","EAR DROPS DRO","6.5%","15","Select","Select",""],["","00054327099","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","50428038612","ACETAMINOPHN TAB","500MG","30","Select","Select",""],["","00536117201","ACETAMIN TAB","500MG","30","Select","Select",""],["","16729008110","NALTREXONE TAB","50MG","30","Select","Select",""],["","70000049001","EARWAX SOL REMOVAL","","15","Select","Select",""],["","55111078401","FEXOFENADINE TAB","180MG","30","Select","Select",""],["","72578000118","DOXYCYCL HYC TAB","100MG","14","Select","Select",""],["","66993007896","FLUTICASONE PROPIONATE HFA","44 MCG","10.6","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":""}]}]}