{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROSLYN  N MCCLENDON","gend":1,"add":"4201 SHEFFIELD ROAD","city":"RICHMOND","state":"VA","zip":"23224-9998","dob":"1960-01-24","age":"","mstatus":"","insh":"20060581*01","cliId":"","pno":8044829465,"cno":8044829465,"email":"","ename":"","eno":"","pphy":"BOHANNON, ARLINE MD","ppno":8048289357,"pcpadd":"417 N 11TH 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":8048284926,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E21.3","I10.","NO DATA","H35.353","Z96.1","H40.1133","Z23.","D35.1","R25.2","M10.9","H40.9","H44.431","H35.81","F80.2","F82.","I12.9","N18.2","E83.52","M17.12","F41.8","Z87.891","M25.50","H35.359","Z72.0","Z79.899","I12.0","H40.1190","R63.5","M85.80","R06.02","M17.0","M25.562","F41.9","F32.9","F17.210","E07.89","R94.39","M19.012"],"date":["2023-02-15","2023-03-06","2023-04-10","2022-04-12","2022-04-12","2022-04-12","2022-10-31","2022-10-31","2022-10-31","2022-10-31","2021-09-10","2021-02-22","2021-09-10","2021-10-19","2021-10-19","2023-04-10","2022-07-29","2022-01-31","2021-07-12","2021-07-12","2023-04-10","2023-04-10","2021-04-23","2021-04-23","2021-06-25","2022-01-31","2022-01-31","2022-01-31","2022-01-31","2022-07-05","2021-01-13","2021-04-06","2021-04-06","2021-04-06","2021-04-06","2022-05-11","2022-07-05","2023-03-21"],"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":[["","00378018105","ALLOPURINOL","300 MG","30","Select","Select",""],["","00254200801","COLCHICINE","TAB 0.6MG","90","Select","Select",""],["","42658012304","IRBESARTAN","300 MG","90","Select","Select",""],["","43547040011","CYCLOBENZAPR","TAB 10MG","60","Select","Select",""],["","61314063705","PREDNISOLONE","SUS 1% OP","5","Select","Select",""],["","24208060203","PROLENSA","SOL 0.0007","3","Select","Select",""],["","24979003703","METOPROL SUC","TAB 25MG ER","90","Select","Select",""],["","49708075441","BROMSITE","DRO 0.00075","5","Select","Select",""],["","67877019910","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","67877069601","CHLORTHALID","TAB 25MG","90","Select","Select",""],["","65862001305","SERTRALINE","TAB 100MG","180","Select","Select",""],["","50383023210","DORZOLAMIDE","SOL 2% OP","10","Select","Select",""],["","61314022715","TIMOLOL MAL","SOL 0.5% OP","15","Select","Select",""],["","24208041115","BRIMONIDINE","SOL 0.2% OP","15","Select","Select",""],["","62037099905","POT CL MICRO","TAB 20MEQ ER","30","Select","Select",""],["","31722051901","HYDRALAZINE","TAB 10MG","90","Select","Select",""],["","16571071601","TRAMADOL HCL","50 MG","20","Select","Select",""],["","57896076315","CALCIUM CARB","CHW 500MG","150","Select","Select",""],["","00536122522","ANTACID","CHW 750MG","96","Select","Select",""],["","00536122922","CALC ANTACID","CHW 750MG","96","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","00536129497","DICLOFENAC","GEL 0.01","200","Select","Select",""],["","00456120330","LINZESS","72 MCG","30","Select","Select",""],["","65162083366","DICLOFENAC SODIUM","1 %","400","Select","Select",""],["","00832532515","POTASSIUM CHLORIDE","20 MEQ","30","Select","Select",""],["","65862001305","SERTRALINE HCL","100 MG","180","Select","Select",""],["","31722051901","HYDRALAZINE HCL","10 MG","90","Select","Select",""],["","00378022201","CHLORTHALIDONE","25 MG","90","Select","Select",""],["","43547040011","CYCLOBENZAPRINE HCL","10 MG","60","Select","Select",""],["","67877019910","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","61314063705","PREDNISOLONE ACETATE","1 %","5","Select","Select",""],["","00378459510","METOPROLOL SUCCINATE","25 MG","90","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":""}]}]}