{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PAUL ALLEN","gend":0,"add":"7496 HUNTER DR","city":"MECHANICSVILLE","state":"VA","zip":"23111-9998","dob":"1960-06-04","age":"","mstatus":"","insh":"20055159*01","cliId":"","pno":8047297450,"cno":8047297450,"email":"","ename":"","eno":"","pphy":"VAN DRIESEN, ASHLEY M NP","ppno":8048287999,"pcpadd":"1300 E MARSHALL ST","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23298-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048285941,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","I10.","E78.5","K86.89","Z76.0","C06.9","K13.79","Z87.891","E10.42","F41.9","G89.18","Z48.3","E11.42","K21.9","K86.1","E78.00","E55.9","F33.9","E66.9","Z68.34","Z46.82","C06.0","C77.0","E83.42","R63.8","Z92.3","E10.649","Z79.899","E13.69","E13.9","Z23.","R52.","E11.65","Z79.4","G89.3","I89.0","R43.2","R51.9","D21.0","D16.5","E11.40","Z79.84","E87.8","F41.8","Z45.2","Z51.11","Z12.11","K64.4","E10.9","Z13.228","C06.89","E66.01","Z68.41","H25.13","H52.03","H52.203","E16.2","E10.22","NO DATA","D64.9","I12.9","H52.4","F33.0","E10.65","Z68.35","Z20.822","Z85.819","R58.","N17.9","R11.0","R79.89","R94.5","Z51.0","Z79.82","R59.0","R33.9"],"date":["2022-09-21","2022-11-15","2023-03-22","2022-03-07","2022-06-06","2023-03-31","2022-09-20","2023-02-24","2022-08-12","2022-11-15","2022-08-14","2022-09-19","2022-11-08","2022-11-15","2022-12-19","2023-03-22","2022-11-15","2022-09-19","2022-11-08","2022-09-19","2022-09-19","2023-02-24","2023-02-24","2022-11-07","2022-12-19","2023-03-31","2023-03-22","2023-03-22","2023-03-22","2023-03-22","2021-03-23","2022-08-19","2022-08-19","2022-08-19","2022-11-21","2023-01-16","2022-12-27","2022-06-23","2022-08-12","2022-08-12","2022-08-16","2022-11-07","2022-09-21","2022-10-19","2022-10-19","2022-11-07","2022-11-08","2022-11-08","2023-02-07","2022-09-20","2022-08-03","2022-10-19","2022-10-19","2023-02-07","2023-02-07","2023-02-07","2022-08-19","2022-11-15","2022-11-15","2022-11-15","2022-11-15","2021-03-09","2022-11-08","2022-08-12","2022-08-12","2022-08-12","2022-08-12","2022-08-12","2022-11-07","2022-11-07","2022-11-07","2022-11-07","2022-11-07","2022-11-07","2023-03-31","2022-09-06"],"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":[["","60505257808","ATORVASTATIN","TAB 10MG","90","Select","Select",""],["","00169210125","NOVOLOG","INJ FLEX REL","15","Select","Select",""],["","59651002090","NIACIN ER","1000 MG","30","Select","Select",""],["","68645058459","METFORMIN","TAB 1000MG","180","Select","Select",""],["","16729009016","FINASTERIDE","TAB 5MG","90","Select","Select",""],["","00032301613","CREON","36K-114K","120","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","00088222033","LANTUS","INJ 100\/ML","50","Select","Select",""],["","00074327590","NIASPAN","TAB 1000 ER","90","Select","Select",""],["","08290320550","BD PEN NEEDL","MIS 32GX4MM","200","Select","Select",""],["","68382000106","PAROXETINE","TAB 40MG","90","Select","Select",""],["","59746033990","LOSARTAN\/HCT","TAB 100-25","90","Select","Select",""],["","00093005405","BUSPIRONE","TAB 10MG","120","Select","Select",""],["","69680013393","POT CHLORIDE","TAB 10MEQ ER","180","Select","Select",""],["","00245531615","KLOR-CON 10","TAB 10MEQ ER","180","Select","Select",""],["","59762501002","CLINDAMYCIN","CAP 300MG","28","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","20","Select","Select",""],["","00904672080","ACETAMIN","TAB 500MG","28","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","6","Select","Select",""],["","00054350049","LIDOCAINE","SOL 2% VISC","400","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","0","COMPOUND"," ","300","Select","Select",""],["","00002751001","HUMALOG","INJ 100\/ML","10","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","28","Select","Select",""],["","57237010099","METOPROL TAR","TAB 25MG","15","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","24","Select","Select",""],["","00126007692","PREVIDENT","PST 5000 BST","100","Select","Select",""],["","00409121501","NALOXONE","INJ 0.4MG\/ML","10","Select","Select",""],["","55111015430","ONDANSETRON","TAB 8MG","30","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","30","Select","Select",""],["","31722070210","LOSARTAN POT","TAB 100MG","30","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","00126007292","PREVDNT 5000","PST 0.011","100","Select","Select",""],["","42858010401","OXYCOD\/APAP","TAB 10-325MG","15","Select","Select",""],["","49502025080","SEMGLEE","SOL 100U\/ML","10","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","36","Select","Select",""],["","68645051554","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","49035032712","GENTLE LAXAT","TAB 5MG EC","4","Select","Select",""],["","10572010101","PEG-3350","SOL ELECTROL","4000","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","Select","Select",""],["","54838011680","SILACE","LIQ 10MG\/ML","473","Select","Select",""],["","00548585000","GLUCAGON","KIT 1MG","2","Select","Select",""],["","49483060710","GABAPENTIN","CAP 400MG","90","Select","Select",""],["","57896010410","ACETAMINOPHE","TAB 325MG","30","Select","Select",""],["","60258017101","MAG OXIDE","TAB 400MG","30","Select","Select",""],["","81131007179","MAGNESIUM","TAB 400MG","30","Select","Select",""],["","45802006003","BACITRACIN","OIN 500\/GM","30","Select","Select",""],["","56151161151","TRUEPLUS","CHW GLUCOSE","50","Select","Select",""],["","00172208380","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","10631028608","LAC-HYDRIN","LOT FIVE","226","Select","Select",""],["","50383066730","LIDO\/PRILOCN","CRE 2.5-2.5%","30","Select","Select",""],["","81131038679","RELION PEN","MIS 32GX4MM","3200","Select","Select",""],["","49502039475","INSULIN GLAR","INJ 100U\/ML","15","Select","Select",""],["","73070010315","INSULIN ASPA","INJ FLEXPEN","30","Select","Select",""],["","59267030402","PFIZER BIVAL","INJ BA4\/BA5","0","Select","Select",""],["","49281072210","FLUBLOK QUAD","INJ 2022-23","0","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","56151162501","TRUEPLS GLUC","GEL 15\/32ML","224","Select","Select",""],["","00002614511","BAQSIMI ONE","POW 3MG\/DOSE","1","Select","Select",""],["","65862059805","TAMSULOSIN HCL","0.4 MG","90","Select","Select",""],["","00088221905","LANTUS SOLOSTAR","100\/ML (3)","27","Select","Select",""],["","00378668910","PANTOPRAZOLE SODIUM","40 MG","30","Select","Select",""],["","53885027150","ONETOUCH VERIO TEST STRIP","","150","Select","Select",""],["","10631028605","LAC-HYDRIN FIVE","5 %","226","Select","Select",""],["","60505257808","ATORVASTATIN CALCIUM","10 MG","90","Select","Select",""],["","00169633910","NOVOLOG FLEXPEN","100\/ML (3)","27","Select","Select",""],["","65862001001","METFORMIN HCL","1000 MG","180","Select","Select",""],["","67877019810","AMLODIPINE BESYLATE","5 MG","90","Select","Select",""],["","00093005405","BUSPIRONE HCL","10 MG","120","Select","Select",""],["","65862018830","ONDANSETRON HCL","8 MG","30","Select","Select",""],["","08290320122","ULTRA-FINE NANO PEN NEEDLE","32GX 5\/32\"","400","Select","Select",""],["","68382000105","PAROXETINE HCL","40 MG","90","Select","Select",""],["","00832532410","POTASSIUM CHLORIDE","10 MEQ","180","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":""}]}]}