{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN DUGAN","gend":0,"add":"12 WEST ROANOKE ST","city":"RICHMOND","state":"VA","zip":"23225-9998","dob":"1966-07-24","age":"","mstatus":"","insh":"20051056*01","cliId":"","pno":8042630210,"cno":8042630210,"email":"","ename":"","eno":"","pphy":"BELLE, CHERYL M MD","ppno":8043258801,"pcpadd":"STE 200 2401 W LEIGH ST,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23220-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8042133051,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M86.10","A49.02","I10.","K59.00","U07.1","R22.43","T80.211A","B37.7","G06.2","D61.818","Z96.653","N40.0","G89.29","D69.6","D70.9","G47.00","E66.9","M54.10","Z20.822","Z87.442","Z86.14","Z86.711","F11.20","F11.120","R61.","B95.62","M86.28","M54.42","F41.9","L02.92","Z21.","R79.9","F33.1","F41.1","R68.89","G06.1","M53.3","M54.9","G64.","D64.9","I44.0","I45.10","M86.9","B49.","M46.40","Z79.899","Z13.220","NO DATA","M51.9","R06.00","R06.83","Z76.0","Z79.891","F31.81","I26.99","F32.9","D46.A","B37.9","R50.9","Z68.37","M54.5","M47.817","A18.01","L85.3","V58.89","A41.9","Z86.16","N20.0","G90.09","F33.9","G57.91","Z87.11","I51.7","I35.1","I77.810","M46.26","M46.46","Z79.2","Z51.81","D75.9","Z23.","Z76.89","Z79.01","M86.18","Z98.890","F40.240","N40.1","R33.8","Z86.61","Z96.659","Z68.38","M25.48","I87.8","R78.81","S61.305A","W27.4XXA","L02.212","Z22.322","M00.00","M62.81","R26.89","R29.898","S61.215A"],"date":["2021-01-24","2021-01-24","2022-02-14","2021-07-08","2021-04-12","2021-04-12","2021-05-01","2021-05-04","2021-05-12","2021-05-06","2021-05-01","2022-02-14","2022-08-22","2021-05-10","2021-05-10","2022-01-10","2021-05-01","2021-05-01","2021-05-01","2021-05-01","2021-05-01","2021-05-12","2023-09-24","2021-06-18","2022-02-14","2022-02-14","2022-02-14","2022-08-22","2022-08-22","2022-02-14","2022-02-14","2022-02-14","2023-07-06","2022-06-16","2021-02-25","2021-05-03","2021-03-18","2021-05-12","2021-04-27","2021-05-10","2021-05-01","2021-05-01","2022-03-25","2021-05-06","2021-06-02","2022-01-10","2021-07-08","2022-01-10","2022-01-10","2022-01-10","2022-01-10","2022-01-10","2022-01-10","2022-08-14","2021-03-25","2021-05-10","2021-05-04","2021-05-12","2022-08-22","2021-03-10","2021-05-06","2021-03-18","2021-03-19","2021-03-24","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-03-04","2021-05-02","2021-05-04","2021-05-04","2021-05-04","2021-11-01","2021-11-01","2021-11-01","2021-11-01","2021-05-19","2021-11-01","2021-02-17","2021-03-14","2021-02-17","2021-02-17","2021-03-14","2021-03-14","2021-03-14","2021-03-14","2021-03-14","2021-03-14","2021-03-19","2021-03-23","2021-05-05","2021-08-20","2021-08-20","2021-03-16","2021-03-16","2021-03-22","2021-04-01","2021-04-01","2021-04-01","2021-08-20"],"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":[["","00003089321","ELIQUIS","TAB 2.5MG","30","Select","Select",""],["","13107000305","MIRTAZAPINE","30 MG","30","Select","Select",""],["","45963055750","GABAPENTIN","400 MG","270","Select","Select",""],["","45963070911","METOPROL SUC","TAB 25MG ER","30","Select","Select",""],["","68180029606","DULOXETINE","CAP 60MG","30","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","00093081001","NORTRIPTYLIN","CAP 10MG","120","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","57896020110","PAIN RELIEF","TAB 500MG","180","Select","Select",""],["","50228038160","QUETIAPINE","TAB 150MG ER","30","Select","Select",""],["","31604002743","MELATONIN","TAB 5MG","30","Select","Select",""],["","49781015051","STOOL SOFTNR","TAB 8.6-50MG","60","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","11534016503","FOLIC ACID","TAB 1MG","30","Select","Select",""],["","50458058090","XARELTO","TAB 10MG","1","Select","Select",""],["","00904672059","ACETAMIN","TAB 500MG","180","Select","Select",""],["","00054039268","METHADONE","CON 10MG\/ML","23","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","10","Select","Select",""],["","50242004164","CATHFLO ACTI","INJ 2MG","1","Select","Select",""],["","47335061930","DRIZALMA","CAP 60MG DR","14","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","30","Select","Select",""],["","47781042647","FENTANYL","DIS 50MCG\/HR","5","Select","Select",""],["","42858030101","HYDROMORPHON","TAB 2MG","30","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","7","Select","Select",""],["","64253011130","NORML SALINE","INJ IV FLUSH","300","Select","Select",""],["","0","COMPOUND"," ","2","Select","Select",""],["","64253022235","HEPARIN LOCK","INJ 10UNT\/ML","300","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","30","Select","Select",""],["","11917006552","ACIDOPHILUS","CAP EX ST","30","Select","Select",""],["","00264220100","SODIUM CHLOR","SOL 0.9% IRR","1000","Select","Select",""],["","23155050110","HYDROXYZ HCL","TAB 25MG","30","Select","Select",""],["","00363017508","PAIN RELIEVE","TAB 500MG","180","Select","Select",""],["","00904672559","SENNA","TAB 8.6MG","30","Select","Select",""],["","00573021541","ANBESOL","LIQ 0.2","12","Select","Select",""],["","00115180301","HYDROXYZ PAM","CAP 25MG","30","Select","Select",""],["","45802086803","POLYETH GLYC","POW 3350 NF","510","Select","Select",""],["","27808023302","DOXYCYCL HYC","CAP 100MG","60","Select","Select",""],["","00456060001","TEFLARO","INJ 600MG","21","Select","Select",""],["","00378001805","METOPROL TAR","TAB 25MG","30","Select","Select",""],["","00363876020","SENNA-S","TAB 8.6-50MG","60","Select","Select",""],["","00536124801","STIMULANT","TAB 8.6-50MG","60","Select","Select",""],["","00536132701","ACETAMINOPHE","TAB 325MG","30","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","51672131201","MUPIROCIN","OIN 0.02","15","Select","Select",""],["","65862044990","VALACYCLOVIR","TAB 1GM","20","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","51672400101","NORTRIPTYLINE HCL","10 MG","120","Select","Select",""],["","67618020016","BETASEPT","4 %","473","Select","Select",""],["","16729010912","QUETIAPINE FUMARATE ER","150 MG","30","Select","Select",""],["","65162010350","GABAPENTIN CAP","400MG","270","Select","Select",""],["","57237000930","MIRTAZAPINE TAB","30MG","30","Select","Select",""],["","55111046601","METOPROL SUC TAB","25MG ER","30","Select","Select",""],["","68180029606","DULOXETINE CAP","60MG","30","Select","Select",""],["","16729010912","QUETIAPINE TAB","150MG ER","30","Select","Select",""],["","00093081001","NORTRIPTYLIN CAP","10MG","120","Select","Select",""],["","68382013201","TAMSULOSIN CAP","0.4MG","30","Select","Select",""],["","51672131201","MUPIROCIN OIN","2%","15","Select","Select",""],["","27808023302","DOXYCYCL HYC CAP","100MG","60","Select","Select",""],["","65862042005","SMZ\/TMP DS TAB","800-160","20","Select","Select",""],["","65862044990","VALACYCLOVIR TAB","1GM","20","Select","Select",""],["","23155013525","DOXYCYCLINE MONOHYDRATE","100 MG","60","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":""}]}]}