{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ARLEEN JACKSON","gend":1,"add":"1501 N 21ST ST APT 417","city":"RICHMOND","state":"VA","zip":"23223-9998","dob":"1955-06-04","age":"","mstatus":"","insh":"20040713*01","cliId":"","pno":8046833027,"cno":8046833027,"email":"","ename":"","eno":"","pphy":"GREEN JR, HAROLD T MD","ppno":8046441665,"pcpadd":"STE 308 1510 N 28TH ST,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23223-9998","pcpcounty":"","pcpid":"","pcpname":"Primary Healthcare Associates","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8046445285,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.9","N39.490","M19.90","F39.","U07.1","R11.2","R10.9","N17.9","J96.01","R10.84","K59.00","S50.02XA","K52.9","F17.200","W19.XXXA","Y92.000","N30.00","I10.","M47.817","E78.00","F17.210","E66.01","E78.5","NO DATA","F41.9","Z68.38","Z79.51","Z79.899","Z87.440","Z98.51","T07.XXXA","V03.10XA","S09.90XA","S16.1XXA","S39.012A","Z72.0","Z04.1"],"date":["2023-03-31","2023-09-22","2023-09-22","2023-08-31","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2023-01-11","2023-01-11","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-02-16","2023-06-28","2021-02-16","2021-12-01","2023-06-28","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2023-06-28","2023-06-28","2023-06-28","2023-06-28","2023-06-28","2023-06-28","2023-06-28"],"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":[["","80681004001","MELATONIN TAB","5MG","30","Select","Select",""],["","31722070210","LOSARTAN POT TAB","100MG","30","Select","Select",""],["","16714071503","OMEPRAZOLE CAP","20MG","30","Select","Select",""],["","29033000301","SUCRALFATE TAB","1GM","120","Select","Select",""],["","43547028810","BUPROPION TAB","100MG SR","30","Select","Select",""],["","50228014601","HYDROCHLOROT CAP","12.5MG","30","Select","Select",""],["","16714045302","QUETIAPINE TAB","50MG","60","Select","Select",""],["","69097012315","TOPIRAMATE TAB","50MG","60","Select","Select",""],["","65162046650","IBUPROFEN TAB","800MG","90","Select","Select",""],["","29300039710","AMLODIPINE TAB","5MG","30","Select","Select",""],["","29300039710","AMLODIPINE BESYLATE","5 MG","30","Select","Select",""],["","51991096257","POLYETHYLENE GLYCOL","3350 17 G\/DOSE","510","Select","Select",""],["","00093221001","SUCRALFATE","1 G","120","Select","Select",""],["","29300014810","QUETIAPINE FUMARATE","50 MG","60","Select","Select",""],["","69097012403","TOPIRAMATE","100 MG","60","Select","Select",""],["","16714063403","OMEPRAZOLE","20 MG","30","Select","Select",""],["","65162046650","IBUPROFEN","800 MG","90","Select","Select",""],["","31722070210","LOSARTAN POTASSIUM","100 MG","30","Select","Select",""],["","00904699880","DOCUSATE SODIUM","100 MG","60","Select","Select",""],["","50804063110","SENNA LAXATIVE","8.6 MG","30","Select","Select",""],["","50228043605","NAPROXEN","500 MG","30","Select","Select",""],["","41167005847","ASPERCREME LIDOCAINE","4 %","30","Select","Select",""],["","69584061250","METHOCARBAMOL","750 MG","15","Select","Select",""],["","50228014601","HYDROCHLOROT","CAP 12.5MG","30","Select","Select",""],["","16714045402","QUETIAPINE","TAB 100MG","30","Select","Select",""],["","80681004001","MELATONIN","TAB 5MG","30","Select","Select",""],["","31722070210","LOSARTAN POT","TAB 100MG","30","Select","Select",""],["","43547028810","BUPROPION","TAB 100MG SR","30","Select","Select",""],["","29300039710","AMLODIPINE","TAB 5MG","30","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":""}]}]}