{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GARY P JAECKEL","gend":0,"add":"613 NEWKIRK DR","city":"RICHMOND","state":"VA","zip":"23224-9998","dob":"1964-01-20","age":"","mstatus":"","insh":"20055918*01","cliId":"","pno":8045021446,"cno":8045021446,"email":"","ename":"","eno":"","pphy":"EDDY, JANET MD","ppno":8047862505,"pcpadd":"700 DINWIDDIE AVE,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23224-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8047832514,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R10.84","K59.03","F41.9","F32.9","R53.83","R63.0","I10.","C22.0","Z68.24","R11.0","Z51.5","K56.609","E87.6","T81.30XA","R11.2","T81.31XA","T81.49XA","L03.311","K74.60","B18.2","F17.210","B35.4","F17.200","Z79.899","Z79.1","R10.33","F05.","R06.4","K56.690","NO DATA","K40.90","Z68.23","T81.89XA","R18.8","B19.20","R10.9","F41.8","G89.3","Z68.25","F33.40","Z68.22","Z79.891","Z91.81","R45.1","N17.9","V62.84","E87.1","D63.8","E86.0","Z66.","L03.90","R53.81","K66.0","Z68.26","M79.604","M79.605","K56.50","R18.0","G89.18"],"date":["2022-02-14","2022-01-11","2022-02-14","2021-11-17","2022-01-11","2021-12-07","2022-02-09","2022-02-16","2021-02-23","2021-09-09","2022-02-16","2021-06-29","2021-06-28","2022-01-11","2022-01-11","2022-01-07","2022-01-07","2022-01-07","2022-01-07","2022-01-07","2022-01-07","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2022-02-13","2022-02-15","2021-06-28","2022-01-11","2021-10-07","2022-01-11","2021-12-29","2022-01-11","2022-02-09","2021-06-25","2021-07-02","2022-02-16","2021-06-25","2021-06-29","2021-09-23","2022-01-07","2022-01-07","2022-02-16","2021-06-25","2021-06-25","2021-06-25","2021-06-25","2021-06-25","2021-06-25","2021-08-24","2021-07-05","2021-11-11","2021-06-15","2021-06-15","2021-06-15","2021-06-25","2021-12-28","2021-12-28"],"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":[["","59011048010","OXYCONTIN","TAB 80MG CR","21","Select","Select",""],["","00406853001","OXYCODONE","TAB 30MG","56","Select","Select",""],["","00781107905","ALPRAZOLAM","TAB 1MG","21","Select","Select",""],["","00378001805","METOPROL TAR","TAB 25MG","15","Select","Select",""],["","33342006807","OLANZAPINE","TAB 5MG","30","Select","Select",""],["","57237024001","ZALEPLON","CAP 10MG","30","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","65862055990","PANTOPRAZOLE","TAB 20MG","30","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","00121087316","LACTULOSE","SOL 10GM\/15","946","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","45","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","7","Select","Select",""],["","51672207502","BACITR ZINC","OIN 500\/GM","28","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","68462018117","CLOTRIMAZOLE","CRE 0.01","15","Select","Select",""],["","59011048010","OXYCONTIN TAB","80MG CR","15","Select","Select",""],["","10702005701","OXYCODONE TAB","20MG","56","Select","Select",""],["","00781108901","ALPRAZOLAM TAB","2MG","21","Select","Select",""],["","68462018117","CLOTRIMAZOLE CRE","1%","15","Select","Select",""],["","51672207502","BACITR ZINC OIN","500\/GM","28","Select","Select",""],["","00054418425","DEXAMETHASON TAB","4MG","7","Select","Select",""],["","57237007710","ONDANSETRON TAB","4MG ODT","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":""}]}]}