{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SIEGFRIED  V REAVES","gend":0,"add":"1127 UPPER APPOMATTOX ST","city":"PETERSBURG","state":"VA","zip":"23803-9998","dob":"1966-07-22","age":"","mstatus":"","insh":"20040339*01","cliId":"","pno":8042553874,"cno":8042553874,"email":"","ename":"","eno":"","pphy":"JIN, XIAO HONG MD","ppno":8047320648,"pcpadd":"15 GOODRICH AVE","pcpcity":"PETERSBURG","pcpstate":"VA","pcpzip":"23805-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048616846,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L30.9","M16.12","G47.33","D17.9","E11.9","E78.5","F17.200","I10.","J44.9","Z79.01","Z79.84","R11.0","L60.0","B35.3","B35.1","E11.59","L85.3","M51.26","M47.817","M47.814","R07.89","F17.210","E66.9","Z68.39","Z00.01","R60.9","Z01.810","Z20.822","Q82.8","J40.","Z72.0","K21.9","J30.9","J01.00","R10.9","H61.23","M54.9","J20.9","E11.8","J06.9","H25.13","H43.813","H04.123","J01.10","R06.00","R06.09","L81.5","L20.84","L81.0","R10.12","R07.9","D86.9","NO DATA","M54.42","M70.62","Z96.642","M54.16","J01.90","Z71.2","S23.3XXA","S33.5XXA","R51.9","Z79.51","R05.1","J44.1"],"date":["2021-03-18","2021-03-23","2023-03-22","2021-09-28","2023-01-20","2023-01-17","2022-12-15","2023-01-17","2022-06-12","2021-09-28","2022-12-28","2021-09-28","2023-03-07","2023-03-07","2023-03-07","2023-03-07","2021-04-25","2022-12-12","2022-12-12","2022-12-12","2021-06-16","2021-06-16","2022-12-28","2022-12-28","2021-07-21","2021-08-31","2021-07-27","2021-07-27","2022-04-26","2022-07-10","2022-12-28","2022-12-15","2022-12-15","2021-02-19","2021-02-19","2022-09-22","2023-01-17","2022-10-18","2022-10-18","2022-12-21","2023-01-20","2023-01-20","2023-01-20","2021-05-18","2021-05-18","2021-07-30","2021-08-05","2021-08-05","2021-08-05","2021-09-28","2021-10-04","2021-10-04","2022-06-12","2022-02-02","2022-02-02","2022-02-02","2022-02-02","2022-03-18","2022-04-08","2022-06-10","2022-06-10","2022-06-12","2022-06-12","2022-08-31","2022-08-31"],"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":[["","70461032103","FLUCLVX QUAD","INJ 2021-22","0","Select","Select",""],["","67877056310","METFORMIN","TAB 1000MG","60","Select","Select",""],["","65862055990","PANTOPRAZOLE","TAB 20MG","60","Select","Select",""],["","68001033508","LISINOPRIL","20 MG","30","Select","Select",""],["","62332042731","BENZONATATE","CAP 200MG","42","Select","Select",""],["","45963043864","ENULOSE","SOL 10GM\/15","600","Select","Select",""],["","00904698640","MUCUS RELIEF","TAB 600MG ER","30","Select","Select",""],["","53885004601","ONETOUCH","KIT ULTRA 2","1","Select","Select",""],["","16729018317","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","45802049326","AMMONIUM LAC","CRE 0.12","385","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","68001043697","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","42571016242","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","56151146004","TRUE METRIX","TES GLUCOSE","100","Select","Select",""],["","65862064163","AZITHROMYCIN","250 MG","6","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","68001036103","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","00472038115","BETAMETH DIP","OIN 0.0005","45","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","4","Select","Select",""],["","24385035934","GNP TUSSIN","LIQ DM","160","Select","Select",""],["","00713022615","TRIAMCINOLON","CRE 0.00025","60","Select","Select",""],["","00378161005","DICYCLOMINE","CAP 10MG","20","Select","Select",""],["","57896045401","GERI-KOT","TAB 8.6MG","60","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","60","Select","Select",""],["","68180018906","MELOXICAM","CAP 10MG","14","Select","Select",""],["","00781261305","AMOXICILLIN","500 MG","30","Select","Select",""],["","27808005701","PROMETHAZINE","SOL DM","280","Select","Select",""],["","63824004124","MUCINEX D","TAB 120-1200","20","Select","Select",""],["","21922000909","DICLOFENAC","GEL 0.01","200","Select","Select",""],["","69584061150","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","65162062711","TRAMADOL HCL","TAB 50MG","6","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","45","Select","Select",""],["","00904688365","ACETAMINOPHE","TAB 650MG ER","60","Select","Select",""],["","62135098505","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","64380078933","LIDOCAINE","OIN 0.05","100","Select","Select",""],["","59746017506","PREDNISONE","20 MG","21","Select","Select",""],["","68001000501","METHYLPRED","TAB 4MG","21","Select","Select",""],["","42571014305","CELECOXIB","CAP 100MG","30","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","00536250676","SALINE MIST","SPR 0.0065","44","Select","Select",""],["","00310461612","BREZTRI AERO","AER SPHERE","11","Select","Select",""],["","69618001001","ACETAMIN","TAB 325MG","40","Select","Select",""],["","68001043697","CETIRIZINE HCL","10 MG","30","Select","Select",""],["","68001036103","MONTELUKAST SODIUM","10 MG","30","Select","Select",""],["","00536114397","PETROLATUM","42 %","100","Select","Select",""],["","00172208380","HYDROCHLOROTHIAZIDE","25 MG","30","Select","Select",""],["","54162050001","HYDROPHOR","42 %","454","Select","Select",""],["","70010006510","METFORMIN HCL","1000 MG","60","Select","Select",""],["","60505082901","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","65862055990","PANTOPRAZOLE SODIUM","20 MG","60","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","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":""}]}]}