{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA M BEGGS","gend":1,"add":"3900 PAULHILL ROAD","city":"RICHMOND","state":"VA","zip":"23236-9998","dob":"1963-08-25","age":"","mstatus":"","insh":"20048708*01","cliId":"","pno":8044474886,"cno":8044474886,"email":"","ename":"","eno":"","pphy":"TAYLOR, GAIL L MD","ppno":8044235050,"pcpadd":"13700 ST FRANCIS BLVD STE 510,","pcpcity":"MIDLOTHIAN","pcpstate":"VA","pcpzip":"23114-9998","pcpcounty":"","pcpid":"","pcpname":"Charter Colony Family Practice","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8044235048,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","Z51.12","C34.91","Z68.43","J45.909","R05.","C34.11","Z90.2","G47.33","U07.1","E66.01","M94.261","M23.203","J44.9","D64.9","J01.90","Z68.42","J31.0","J45.901","J32.9","C34.90","R51.9","Z71.9","D50.9","J18.9","Z99.81","Z20.822","I10.","Z79.52","Z85.118","Z79.899","R07.89","F33.9","F41.9","F41.0","Z20.828","R00.2","M79.7","E55.9","Z12.31","Z12.11","E03.2","M25.561","M17.11","R06.00","H02.102","H02.105","H02.403","H53.453","J40.","J30.9","R13.10","Z86.59","R06.02","Z87.891","Z79.84","R07.9","NO DATA","H02.831","H02.834","Z41.1","Z20.3","S51.852A","Z23.","Z29.14","E78.00","R63.5","W55.01XA","R06.09"],"date":["2023-09-19","2021-04-28","2023-08-22","2021-04-28","2022-03-11","2021-04-13","2022-06-01","2021-09-21","2023-09-19","2022-03-11","2023-09-19","2022-06-02","2022-06-02","2023-03-07","2023-01-13","2023-01-13","2023-08-22","2023-03-07","2023-09-19","2023-01-25","2021-10-03","2021-02-03","2021-10-04","2022-05-31","2022-05-04","2022-02-14","2022-05-01","2023-09-19","2022-05-01","2023-09-19","2022-05-01","2022-05-01","2021-11-11","2021-11-11","2021-11-11","2021-08-30","2023-08-22","2021-11-11","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2021-10-27","2021-10-27","2022-01-27","2023-04-21","2023-04-21","2023-04-21","2023-02-14","2022-01-05","2021-05-18","2021-05-18","2022-03-22","2023-05-22","2023-08-22","2021-01-18","2023-08-22","2023-04-21","2023-04-21","2023-04-21","2023-04-21","2023-06-20","2023-06-17","2023-06-20","2023-06-20","2023-09-19","2023-06-20","2023-06-17","2023-08-22"],"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":[["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","100","Select","Select",""],["","67877056110","METFORMIN","TAB 500MG","60","Select","Select",""],["","00378180310","LEVOTHYROXIN","TAB 50MCG","90","Select","Select",""],["","53885039310","ONETOUCH US","MIS LANCETS","100","Select","Select",""],["","69097012503","TOPIRAMATE","TAB 200MG","30","Select","Select",""],["","00054021125","PROTRIPTYLIN","TAB 10MG","90","Select","Select",""],["","53885004401","ONE TOUCH","KIT VERIO FL","1","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","50","Select","Select",""],["","47335075649","IPRATROPIUM\/","SOL ALBUTER","180","Select","Select",""],["","55111029336","SUMATRIPTAN","TAB 100MG","9","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","27808008602","HYD POL\/CPM","SUS 10-8\/5ML","70","Select","Select",""],["","59310057922","PROAIR HFA","AER ","26","Select","Select",""],["","00186037020","SYMBICORT","160-4.5MCG","30.6","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","00378064110","PREDNISONE","10 MG","39","Select","Select",""],["","50111056101","TRAZODONE","TAB 100MG","90","Select","Select",""],["","68382003516","VENLAFAXINE","CAP 75MG ER","90","Select","Select",""],["","70436001002","BUPROPN HCL","TAB 150MG XL","270","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","21","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","4","Select","Select",""],["","49483060450","IBUPROFEN","800 MG","30","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","16729020201","BUSPIRONE","TAB 10MG","120","Select","Select",""],["","69452015120","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","68180016011","AZITHROMYCIN","250 MG","6","Select","Select",""],["","75834015905","VERAPAMIL","TAB 240MG ER","90","Select","Select",""],["","67877057505","BENZONATATE","CAP 200MG","90","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","90","Select","Select",""],["","43598029290","PREGABALIN","CAP 50MG","60","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","00597016061","SPIRIVA","AER 1.25MCG","4","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","52268020101","SUTAB","TAB ","24","Select","Select",""],["","65862053820","LEVOFLOXACIN","TAB 750MG","7","Select","Select",""],["","65862009620","CEFPODOXIME","TAB 200MG","10","Select","Select",""],["","75834015905","VERAPAMIL ER","240 MG","90","Select","Select",""],["","70436001002","BUPROPION XL","150 MG","270","Select","Select",""],["","00597016061","SPIRIVA RESPIMAT","1.25 MCG","4","Select","Select",""],["","00378180710","LEVOTHYROXINE SODIUM","88 MCG","30","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","53885000810","ONETOUCH DELICA PLUS LANCET","33 GAUGE","100","Select","Select",""],["","31722070430","VALACYCLOVIR","500 MG","40","Select","Select",""],["","24208091055","ERYTHROMYCIN","5 MG\/GRAM","3.5","Select","Select",""],["","67877056110","METFORMIN HCL","500 MG","60","Select","Select",""],["","53885027025","ONETOUCH VERIO TEST STRIP","","25","Select","Select",""],["","65862050320","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","9","Select","Select",""],["","00002143380","TRULICITY","0.75MG\/0.5","2","Select","Select",""],["","70377002911","ATORVASTATIN CALCIUM","40 MG","90","Select","Select",""],["","69097083412","SERTRALINE HCL","50 MG","90","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","47335075649","IPRATROPIUM-ALBUTEROL","0.5-3MG\/3","180","Select","Select",""],["","65862057490","MONTELUKAST SODIUM","10 MG","90","Select","Select",""],["","08290320119","ULTRA-FINE MINI PEN NEEDLE","31 GX3\/16\"","100","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","69097083412","SERTRALINE TAB","50MG","90","Select","Select",""],["","00378064110","PREDNISONE TAB","10MG","39","Select","Select",""],["","68180016006","AZITHROMYCIN TAB","250MG","4","Select","Select",""],["","00378180310","LEVOTHYROXIN TAB","50MCG","90","Select","Select",""],["","00597016061","SPIRIVA AER","1.25MCG","4","Select","Select",""],["","00054327099","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","4","Select","Select",""],["","00093317431","ALBUTEROL AER HFA","","8","Select","Select",""],["","49483060450","IBUPROFEN TAB","800MG","30","Select","Select",""],["","59310057922","PROAIR HFA AER","","26","Select","Select",""],["","65862057490","MONTELUKAST TAB","10MG","90","Select","Select",""],["","70436001002","BUPROPN HCL TAB","150MG XL","90","Select","Select",""],["","75834015905","VERAPAMIL TAB","240MG ER","30","Select","Select",""],["","00186037020","SYMBICORT AER","160-4.5","31","Select","Select",""],["","00310737020","BUDES\/FORMOT AER","160-4.5","10","Select","Select",""],["","70377002911","ATORVASTATIN TAB","40MG","90","Select","Select",""],["","65862053820","LEVOFLOXACIN TAB","750MG","7","Select","Select",""],["","69097012503","TOPIRAMATE TAB","200MG","90","Select","Select",""],["","67877056110","METFORMIN TAB","500MG","60","Select","Select",""],["","47335075649","IPRATROPIUM\/ SOL ALBUTER","","180","Select","Select",""],["","65862009620","CEFPODOXIME TAB","200MG","10","Select","Select",""],["","53885000810","ONETOUCH DEL MIS PLUS","33G","100","Select","Select",""],["","53885027210","ONETOUCH TES VERIO","","100","Select","Select",""],["","00310737020","BUDESONIDE-FORMOTEROL FUMARATE","160-4.5MCG","30.6","Select","Select",""],["","49281024658","IMOVAX RABIES VACCINE","2.5 UNIT","1","Select","Select",""],["","16571082201","LORATADINE","10 MG","30","Select","Select",""],["","00169418113","OZEMPIC .","25 OR 0.5","9","Select","Select",""],["","00169406012","VICTOZA","2-PAK 0.6 MG\/0.1","6","Select","Select",""],["","53489011905","DOXYCYCLINE HYCLATE","100 MG","14","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":""}]}]}