{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"REBECCA  S WINTINK","gend":1,"add":"11325 CHURCH ROAD","city":"HENRICO","state":"VA","zip":"23233-9998","dob":"1981-01-13","age":"","mstatus":"","insh":"20054130*01","cliId":"","pno":8042521294,"cno":8042521294,"email":"","ename":"","eno":"","pphy":"DESHMUKH, PRAVIN M MD","ppno":8046122980,"pcpadd":"STE 204 12320 W BROAD ST,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23233-9998","pcpcounty":"","pcpid":"","pcpname":"Bon Secours Short Pump Primary Care","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8043602437,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N39.3","K21.9","K04.7","R00.1","F29.","F19.20","F11.20","R50.9","Z20.822","R30.0","K02.52","Z23.","Z00.00","Z12.31","F19.10","F17.210","NO DATA","F41.9","F41.0","M25.50","E55.9","R12.","Z68.26","S59.912A","R41.0","R47.81","Y28.9XXA","E78.00","Z79.899","S41.112A","Z87.891","Z53.29","W22.09XA","K02.51","R51.9","R41.82","F14.20","F13.20","F99.","U07.1"],"date":["2023-01-23","2023-01-23","2021-08-30","2022-09-17","2022-09-26","2022-09-26","2022-10-11","2023-01-03","2023-01-03","2021-04-18","2021-04-18","2022-02-28","2022-02-28","2023-01-23","2022-09-17","2022-09-17","2023-04-13","2023-01-23","2023-01-23","2023-01-23","2023-01-23","2023-01-23","2023-01-23","2023-04-13","2023-04-13","2023-04-13","2023-04-13","2022-07-26","2022-07-26","2023-04-13","2023-04-13","2023-04-13","2023-04-13","2021-06-23","2023-04-13","2023-04-13","2022-09-26","2022-09-26","2022-09-26","2022-09-26"],"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":[["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","68382025601","OXYBUTYNIN","TAB 10MG ER","30","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","80681017000","VITAMIN D","3 50 MCG","90","Select","Select",""],["","16714069211","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","23155050201","HYDROXYZ HCL","TAB 50MG","30","Select","Select",""],["","68462022001","LITHIUM CARB","CAP 150MG","60","Select","Select",""],["","00536589688","NICOTINE TD","DIS 21MG\/24H","14","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","15","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","60","Select","Select",""],["","45963055650","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","62756079713","DIVALPROEX","TAB 250MG DR","60","Select","Select",""],["","00378425001","DOXEPIN HCL","CAP 50MG","30","Select","Select",""],["","57896050110","ONE-DAILY","TAB MULT-VIT","30","Select","Select",""],["","33342006844","OLANZAPINE","TAB 5MG","30","Select","Select",""],["","10370010103","BUPROPN HCL","TAB 150MG XL","30","Select","Select",""],["","31722053405","METHOCARBAM","TAB 750MG","30","Select","Select",""],["","55111068305","IBU","TAB 600MG","30","Select","Select",""],["","00093083205","CLONAZEPAM","0.5 MG","15","Select","Select",""],["","68382025601","OXYBUTYNIN CHLORIDE ER","10 MG","90","Select","Select",""],["","00378668910","PANTOPRAZOLE SODIUM","40 MG","90","Select","Select",""],["","70436001002","BUPROPION XL","150 MG","30","Select","Select",""],["","69097014260","ALBUTEROL SULFATE HFA","90 MCG","6.7","Select","Select",""],["","62332058131","DICLOFENAC SODIUM","3 %","100","Select","Select",""],["","39328002515","LIDOCAINE","5 %","30","Select","Select",""],["","45802006435","TRIAMCINOLONE ACETONIDE","0.1 %","15","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","69097014260","ALBUTEROL AER HFA","","7","Select","Select",""],["","68382025601","OXYBUTYNIN TAB","10MG ER","30","Select","Select",""],["","00378668910","PANTOPRAZOLE TAB","40MG","30","Select","Select",""],["","53746010901","HYDROCO\/APAP TAB","5-325MG","15","Select","Select",""],["","59746000103","METHYLPRED TAB","4MG","21","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","4","Select","Select",""],["","45963055650","GABAPENTIN CAP","300MG","30","Select","Select",""],["","10370010103","BUPROPN HCL TAB","150MG XL","30","Select","Select",""],["","31722053405","METHOCARBAM TAB","750MG","30","Select","Select",""],["","33342006844","OLANZAPINE TAB","5MG","30","Select","Select",""],["","23155050201","HYDROXYZ HCL TAB","50MG","30","Select","Select",""],["","62756079713","DIVALPROEX TAB","250MG DR","60","Select","Select",""],["","00378425001","DOXEPIN HCL CAP","50MG","30","Select","Select",""],["","00536589688","NICOTINE TD DIS","21MG\/24H","14","Select","Select",""],["","68180012202","CEPHALEXIN CAP","500MG","14","Select","Select",""],["","16714069211","FLUCONAZOLE TAB","150MG","2","Select","Select",""],["","68462022001","LITHIUM CARB CAP","150MG","60","Select","Select",""],["","55111068305","IBU TAB","600MG","30","Select","Select",""],["","50111033402","METRONIDAZOL TAB","500MG","14","Select","Select",""],["","57896050110","ONE-DAILY TAB MULT-VIT","","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":""}]}]}