{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SANDAY  E SMITH","gend":1,"add":"4805 ORIOLE AVE","city":"RICHMOND","state":"VA","zip":"23234-9998","dob":"1958-07-16","age":"","mstatus":"","insh":"20035278*01","cliId":"","pno":8042991170,"cno":8042991170,"email":"","ename":"","eno":"","pphy":"CARTER, RENEE Y MD","ppno":8045608950,"pcpadd":"9000 STONY POINT PARKWAY,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23235-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8043278822,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.12","NO DATA","M25.552","F41.9","R91.8","J44.9","F17.210","K76.0","R10.13","K13.70","J35.8","Z72.0","K92.2","I21.4","F10.10","R94.31","H25.12","H25.11","H04.123","K63.5","K64.8","K64.4","R10.31","K52.9","I10.","B18.2","F17.200","R91.1","H10.13","G89.29","E78.2","I70.90","R01.1","M89.8X1","L28.0","N90.89","Z11.3","Z86.19","Z57.8","K92.0","K31.89","K25.9","Z20.828","N95.0","R04.0","M54.2","M25.512","M25.559","R77.8","Z87.891","M54.16","K21.9","J38.1","J34.2","N84.0","Q51.4","N85.00","Q21.0","I36.1","I37.1","L73.8","E78.5","T74.21XA","I25.10","Z23.","K27.9","Z01.818","Z11.59","Z09.","R74.8","K25.4","T39.395A","K29.80","K70.10","Z79.51","Z98.42","H10.45","H52.4","Z01.419","Z12.31","Z12.11","H25.13","D12.2","M26.601","K25.7","Z00.00","R06.02","Z13.820","L98.9","Z78.0"],"date":["2023-06-27","2022-07-13","2022-02-03","2021-12-15","2021-12-08","2023-05-31","2023-05-31","2023-07-18","2022-03-29","2022-05-16","2022-05-16","2023-06-27","2022-07-13","2022-07-13","2022-07-13","2022-07-26","2022-11-07","2022-11-28","2023-01-17","2022-09-06","2022-09-06","2022-09-06","2022-09-06","2022-09-06","2023-06-27","2023-06-14","2023-02-08","2021-12-08","2021-12-15","2022-07-13","2023-06-27","2021-12-15","2022-05-26","2021-12-15","2022-08-16","2022-06-14","2022-06-14","2023-07-18","2022-06-14","2022-08-05","2023-05-31","2023-05-31","2021-09-05","2021-12-17","2022-06-29","2022-04-05","2022-04-05","2022-04-05","2022-07-13","2022-12-08","2022-06-10","2023-07-18","2022-06-29","2022-06-29","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2022-07-13","2022-07-13","2022-08-16","2022-10-05","2022-10-05","2023-06-27","2023-06-27","2022-10-05","2022-10-05","2021-12-15","2022-08-05","2022-08-05","2022-07-13","2022-07-13","2022-07-13","2022-07-13","2022-07-13","2023-01-17","2023-01-17","2023-01-17","2022-06-07","2022-06-07","2022-06-07","2022-06-08","2022-09-06","2023-05-30","2023-05-31","2023-06-27","2023-06-27","2023-06-27","2023-06-27","2023-06-27"],"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":[["","59267102504","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","62332050203","OLOPATADINE","SOL 0.002","2","Select","Select",""],["","49035061501","EQ ITCHY EYE","DRO 0.025%OP","5","Select","Select",""],["","00781261305","AMOXICILLIN","500 MG","4","Select","Select",""],["","00536468010","VITAMIN B-1","TAB 100MG","30","Select","Select",""],["","17478071710","KETOTIF FUM","DRO 0.025%OP","5","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","Select","Select",""],["","51672402601","KETOCONAZOLE","TAB 200MG","6","Select","Select",""],["","21922001704","CLOBETASOL","OIN 0.0005","30","Select","Select",""],["","60758011910","PREDNISOLONE","SUS 1% OP","10","Select","Select",""],["","17478071310","OFLOXACIN","DRO 0.3% OP","5","Select","Select",""],["","69315012710","FOLIC ACID","TAB 1000MCG","30","Select","Select",""],["","00093505998","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","31722071390","PANTOPRAZOLE SODIUM","40 MG","30","Select","Select",""],["","29300041519","CYCLOBENZAPRINE HCL","10 MG","10","Select","Select",""],["","70700015010","OMEPRAZOLE","20 MG","180","Select","Select",""],["","59267030402","PFIZER COVID BIVAL (","12Y UP)EUA 30 MCG\/0.3","0.3","Select","Select",""],["","59267102504","PFIZER VACC INJ ADLT RTU","","0","Select","Select",""],["","00781261305","AMOXICILLIN CAP","500MG","4","Select","Select",""],["","62332050203","OLOPATADINE SOL","0.2%","2","Select","Select",""],["","31722071390","PANTOPRAZOLE TAB","40MG","60","Select","Select",""],["","69315012710","FOLIC ACID TAB","1000MCG","30","Select","Select",""],["","51672402601","KETOCONAZOLE TAB","200MG","6","Select","Select",""],["","17478071710","KETOTIF FUM DRO","0.025%OP","5","Select","Select",""],["","00536468010","VITAMIN B-","1 TAB 100MG","30","Select","Select",""],["","21922001604","CLOBETASOL CRE","0.05%","15","Select","Select",""],["","49035061501","EQ ITCHY EYE DRO","0.025%OP","5","Select","Select",""],["","17478071310","OFLOXACIN DRO","0.3% OP","5","Select","Select",""],["","60758011910","PREDNISOLONE SUS","1% OP","10","Select","Select",""],["","43386009019","GAVILYTE-G SOL","","4000","Select","Select",""],["","21922001704","CLOBETASOL OIN","0.05%","30","Select","Select",""],["","00093505998","ATORVASTATIN TAB","20MG","30","Select","Select",""],["","72205001390","PREGABALIN","75 MG","30","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4 MG","21","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":""}]}]}