{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KINNUS SETTLE","gend":0,"add":"6557 N STEVENS HOLLOW DR","city":"CHESTERFIELD","state":"VA","zip":"23832-9998","dob":"1972-04-04","age":"","mstatus":"","insh":"20063627*01","cliId":"","pno":8044428414,"cno":8044428414,"email":"","ename":"","eno":"","pphy":"ROSE, ANDREW MD","ppno":8047175300,"pcpadd":"SUITE 117 16011 IRONBRIDGE ROAD,","pcpcity":"CHESTER","pcpstate":"VA","pcpzip":"23831-9998","pcpcounty":"","pcpid":"","pcpname":"Ironbridge Family Practice","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8047487269,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","Z45.09","R55.","F31.9","N50.819","G95.9","Z47.89","M75.42","M54.12","S06.0X0S","M48.02","R20.2","I67.2","R29.818","Z20.822","G81.91","F17.200","F44.9","H53.2","M50.20","R51.9","Z91.030","Z91.018","W19.XXXA","M50.021","M50.022","M50.023","B35.3","L85.3","I49.9","I63.9","R20.0","R53.1","R25.3","N52.9","R30.0","N50.82","F43.20","I07.1","R00.1","I69.351","F17.210","R56.9","Z95.818","M54.2","Z98.1","R29.5","M99.09","I69.359","F39.","Z68.24","K40.20","R39.9","R68.82","N50.89","M25.512","M75.40","Z95.0","Z86.73","F31.30","Z01.812","R10.30","L90.5","M25.511","Z03.89","M48.8X2","N41.9","R10.2","Z79.899","F31.4","F41.1","F60.2","F43.10","G81.94","I20.9","M50.30","R29.700","Z76.5","Z04.9","G62.9","I10.","Z86.11","R07.89"],"date":["2021-07-11","2021-10-26","2021-10-26","2023-09-01","2022-04-21","2022-01-10","2022-02-24","2022-07-01","2023-09-01","2021-03-30","2023-09-01","2023-09-01","2021-06-07","2021-07-12","2022-01-14","2021-06-28","2022-03-29","2021-06-28","2021-06-28","2021-06-28","2021-06-28","2023-09-01","2023-09-01","2021-09-20","2022-01-18","2022-01-18","2022-01-18","2021-04-12","2021-03-10","2021-06-06","2021-06-06","2023-09-01","2023-08-31","2021-07-30","2022-04-21","2021-10-18","2021-10-18","2022-01-05","2021-06-04","2021-06-04","2021-06-09","2023-09-01","2021-06-28","2022-01-31","2022-01-27","2023-09-01","2021-06-07","2021-06-28","2021-07-07","2023-09-18","2022-02-07","2021-11-23","2022-02-17","2022-02-17","2022-02-17","2022-07-20","2022-07-01","2022-07-20","2023-09-01","2021-07-27","2022-01-14","2022-02-07","2022-02-07","2022-07-20","2021-06-03","2021-06-03","2022-04-21","2022-04-28","2023-09-01","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2021-06-03","2021-06-03","2023-09-18","2021-06-03","2021-06-03","2021-06-26","2023-09-18","2023-09-01","2023-09-01","2023-08-31"],"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":[["","00781598801","CARBAMAZEPIN","TAB 400MG ER","60","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","60","Select","Select",""],["","51672127502","CLOTRIMAZOLE","CRE 0.01","60","Select","Select",""],["","68462029817","CLOTRIM\/BETA","CRE DIPROP","15","Select","Select",""],["","51672130104","AMMONIUM LAC","CRE 0.12","280","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","30","Select","Select",""],["","51862054201","BUT\/APAP\/CAF","CAP ","20","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","10","Select","Select",""],["","00832105415","BACLOFEN","TAB 10MG","15","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","15","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","65162010211","GABAPENTIN","CAP 300MG","60","Select","Select",""],["","57237011490","ALFUZOSIN","TAB 10MG ER","30","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","84","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","28","Select","Select",""],["","68382013210","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","00078051205","TEGRETOL-XR","TAB 400MG","60","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","59267102501","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","49035030882","PAIN RELIEVR","TAB 500MG","40","Select","Select",""],["","29300041519","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","49035013606","EQ LIDOCAINE","PAD 0.04","5","Select","Select",""],["","49035048482","ACETAMINOPHN","TAB 500MG","40","Select","Select",""],["","65162019011","NAPROXEN","TAB 500MG","20","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","30","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00078051205","TEGRETOL XR","400 MG","60","Select","Select",""],["","49035090410",""," ","40","Select","Select",""],["","50111056001","TRAZODONE HCL","50 MG","60","Select","Select",""],["","31722099601","HYDROCO\/APAP TAB","5-325MG","28","Select","Select",""],["","65862042005","SMZ\/TMP DS TAB","800-160","60","Select","Select",""],["","65162010211","GABAPENTIN CAP","300MG","60","Select","Select",""],["","68382013210","TAMSULOSIN CAP","0.4MG","30","Select","Select",""],["","00781598801","CARBAMAZEPIN TAB","400MG ER","60","Select","Select",""],["","50111056001","TRAZODONE TAB","50MG","60","Select","Select",""],["","59267102501","PFIZER VACC INJ ADLT RTU","","0","Select","Select",""],["","00093031401","KETOROLAC TAB","10MG","20","Select","Select",""],["","49035030882","PAIN RELIEVR TAB","500MG","40","Select","Select",""],["","29300041519","CYCLOBENZAPR TAB","10MG","15","Select","Select",""],["","00078051205","TEGRETOL-XR TAB","400MG","60","Select","Select",""],["","42806040021","METHYLPRED TAB","4MG","21","Select","Select",""],["","49035013606","EQ LIDOCAINE PAD","4%","5","Select","Select",""],["","49035048482","ACETAMINOPHN TAB","500MG","40","Select","Select",""],["","65162019011","NAPROXEN TAB","500MG","20","Select","Select",""],["","00603533831","PREDNISONE PAK","10MG","48","Select","Select",""],["","66993001968","ALBUTEROL AER HFA","","18","Select","Select",""],["","59746017509","PREDNISONE TAB","20MG","10","Select","Select",""],["","42806071401","BENZONATATE CAP","100MG","30","Select","Select",""],["","16571068201","CARBAMAZEPINE ER","400 MG","60","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","69238131109","PREGABALIN","50 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":""}]}]}