{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHARON  D MARTIN","gend":1,"add":"2025 E MAIN ST STE 105","city":"RICHMOND","state":"VA","zip":"23223-9998","dob":"1958-08-16","age":"","mstatus":"","insh":"20048232*01","cliId":"","pno":7573935300,"cno":7573935300,"email":"","ename":"","eno":"","pphy":"ANDERSON, MICHAEL S MD","ppno":4346346101,"pcpadd":"6 DOCTORS DRIVE","pcpcity":"EMPORIA","pcpstate":"VA","pcpzip":"23847-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4346347107,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F20.9","E11.69","I10.","E27.8","B18.2","F14.20","R10.9","Z79.899","I50.30","F19.94","R03.0","F33.9","I16.1","F14.90","R77.8","Z68.31","E87.6","E83.51","N28.9","N39.0","R44.0","E66.9","F33.0","Z20.828","F39.","N17.8","E11.21","R80.8","R33.9","D35.01","V62.84","E11.9","Z79.4","Z86.19","Z90.5","F17.200","R11.2","R19.7","F25.1","F25.0","E11.65","K42.9","F33.1","I16.0","N18.9","F31.30","F14.10","Z59.00","R29.6","Z71.3","F43.20","G93.41","N17.9","I24.8","E11.22","F17.210","I12.9","R79.89","E87.5","F11.20","F31.9"],"date":["2023-03-19","2022-07-19","2023-04-26","2022-07-19","2023-04-26","2023-01-27","2022-12-16","2023-02-01","2023-03-07","2022-10-04","2022-07-21","2022-10-04","2023-03-07","2023-03-08","2023-03-08","2023-03-08","2022-12-16","2022-12-16","2022-12-16","2022-12-16","2022-07-16","2023-03-06","2022-07-25","2022-10-10","2023-03-07","2023-03-16","2023-03-16","2023-03-16","2023-03-16","2023-03-16","2022-07-12","2023-04-26","2022-07-23","2022-07-23","2023-04-26","2023-03-29","2022-11-15","2022-11-15","2023-03-02","2022-07-14","2023-03-06","2023-03-06","2023-04-26","2023-03-16","2023-04-26","2023-03-16","2023-04-17","2023-03-29","2023-03-29","2023-03-29","2023-04-12","2023-03-06","2023-03-06","2023-03-06","2023-03-06","2023-03-06","2023-03-06","2023-03-06","2023-03-06","2023-03-06","2023-03-06"],"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":[["","65862020299","LOSARTAN POT","TAB 50MG","30","Select","Select",""],["","53885004401","ONE TOUCH","KIT VERIO FL","1","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","50","Select","Select",""],["","08290305930","INSULIN SYRG","MIS 1ML\/29G","30","Select","Select",""],["","00088222033","LANTUS","INJ 100\/ML","10","Select","Select",""],["","24979000912","NIFEDIPINE","TAB 90MG ER","30","Select","Select",""],["","53489014310","SPIRONOLACT","TAB 25MG","15","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","08290320550","BD PEN NEEDL","MIS 32GX5\/32","100","Select","Select",""],["","63304082905","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","13","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","100","Select","Select",""],["","43598096830","ARIPIPRAZOLE","TAB 15MG","30","Select","Select",""],["","00228212810","CLONIDINE","TAB 0.2MG","7","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","15","Select","Select",""],["","69097083305","SERTRALINE","TAB 25MG","30","Select","Select",""],["","10006073038","MAG OXIDE","TAB 400MG","6","Select","Select",""],["","20555000500","CALCIUM","TAB 600MG","4","Select","Select",""],["","00245531911","KLOR-CON M20","TAB 20MEQ ER","6","Select","Select",""],["","67877054360","CEFDINIR","CAP 300MG","14","Select","Select",""],["","00904635761","RISPERIDONE","0.25 MG","30","Select","Select",""],["","50742026201","NIFEDIPINE ER","90 MG","30","Select","Select",""],["","49884002201","ISOSORBIDE DINITRATE","20 MG","90","Select","Select",""],["","67877024910","QUETIAPINE FUMARATE","50 MG","30","Select","Select",""],["","49502039475","INSULIN GLARGINE-YFGN","100\/ML (3)","30","Select","Select",""],["","68382009405","CARVEDILOL","12.5 MG","60","Select","Select",""],["","68180035302","SERTRALINE HCL","100 MG","30","Select","Select",""],["","70377002913","ATORVASTATIN CALCIUM","40 MG","30","Select","Select",""],["","08290320119","ULTRA-FINE MINI PEN NEEDLE","31 GX3\/16\"","100","Select","Select",""],["","45802086803","POLYETHYLENE GLYCOL","3350 17 G\/DOSE","510","Select","Select",""],["","00002771559","BASAGLAR KWIKPEN U-","100 100\/ML (3)","3","Select","Select",""],["","08290320550","NANO","2ND GEN PEN NEEDLE 32GX 5\/32\"","100","Select","Select",""],["","42799060501","LOPERAMIDE","2 MG","42","Select","Select",""],["","64380073408","HYDRALAZINE HCL","25 MG","90","Select","Select",""],["","68001024617","ONDANSETRON ODT","4 MG","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":""}]}]}