{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HOPE  M DYER MCMANUS","gend":1,"add":"22841 GENITO ROAD","city":"AMELIA COURT HOUSE","state":"VA","zip":"23002-9998","dob":"1967-10-03","age":"","mstatus":"","insh":"20079495*01","cliId":"","pno":8045360654,"cno":8045360654,"email":"","ename":"","eno":"","pphy":"HEARST, BRITTANY A MD","ppno":8042769305,"pcpadd":"2500 POCOSHOCK PL","pcpcity":"NORTH CHESTERFIELD","pcpstate":"VA","pcpzip":"23235-9998","pcpcounty":"","pcpid":"","pcpname":"Bon Secours Chesterfield Family Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8046744145,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F34.9","F43.23","F31.60","F41.1","F34.0","Z98.890","M54.2","Z98.1","M51.26","F31.9","F31.89","K14.0","K57.90","E27.8","R10.13","M54.12","M48.02","E87.6","M43.22","M96.843","Z01.419","R11.0","G89.29","Z11.59","F41.9","G43.809","Z68.26","M54.6","R74.8","NO DATA","Z79.899","F31.81","Z47.89","M75.42","G89.18","F34.1","G47.00","G89.4","R19.7","M79.602","G43.001","K57.30","M19.90","F17.210","Z79.51","D35.01","M43.06","M96.830","Z82.49","Z98.51","Z96.642","G43.909","R41.3","Z68.28","R93.5","M47.816","M51.36","M25.552","M54.16","G25.0","E55.9","G43.919","R19.00","M75.112","M19.012","Z87.898","Z86.69","R13.10","K92.2","D64.9","E83.42","R22.2","Z09.","Z68.27","D62.","J44.9","F17.200","R94.31"],"date":["2022-07-14","2022-07-14","2022-10-25","2023-04-11","2022-12-29","2022-09-29","2023-01-20","2023-01-20","2023-01-20","2023-04-24","2023-03-03","2022-02-25","2022-02-18","2022-02-18","2023-03-31","2022-09-29","2022-09-29","2022-09-30","2022-09-30","2022-09-30","2022-11-22","2023-04-10","2022-09-29","2022-01-27","2023-03-27","2022-01-27","2022-07-15","2022-02-09","2022-07-15","2022-11-29","2022-02-25","2022-07-21","2022-11-09","2022-11-09","2022-11-29","2022-02-15","2023-01-05","2022-06-28","2022-07-15","2022-07-01","2022-07-01","2022-02-18","2022-02-18","2022-09-29","2022-02-18","2023-04-10","2022-04-08","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-11-29","2022-11-29","2022-11-29","2022-03-14","2022-12-09","2022-03-30","2022-04-22","2022-12-09","2022-07-15","2022-08-25","2022-08-25","2023-02-11","2023-02-06","2023-02-06","2022-04-22","2022-04-22","2022-11-29","2023-04-10","2023-04-10","2023-04-10","2023-04-10","2023-04-10","2023-04-10","2023-03-28","2023-03-28","2023-03-28","2023-03-24"],"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":[["","00406012505","HYDROCO\/APAP","TAB 10-325MG","40","Select","Select",""],["","43547027609","DONEPEZIL","TAB 10MG","30","Select","Select",""],["","59148004013","REXULTI","TAB 4MG","30","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","60","Select","Select",""],["","00093216568","NALOXONE HCL","SPR ","2","Select","Select",""],["","68382010101","VENLAFAXINE","TAB 100MG","30","Select","Select",""],["","68462010905","TOPIRAMATE","TAB 100MG","60","Select","Select",""],["","00093506201","HYDROXYZ HCL","TAB 50MG","60","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","68180035302","SERTRALINE","TAB 100MG","30","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","90","Select","Select",""],["","00781107905","ALPRAZOLAM","1 MG","60","Select","Select",""],["","70954006020","PREDNISONE","TAB 20MG","13","Select","Select",""],["","69238208101","PROPRANOLOL","TAB 80MG","180","Select","Select",""],["","00406052301","OXYCOD\/APAP","TAB 10-325MG","15","Select","Select",""],["","29300042110","AMITRIPTYLIN","TAB 50MG","30","Select","Select",""],["","69452015120","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","68382005005","MELOXICAM","TAB 7.5MG","30","Select","Select",""],["","61874011520","VRAYLAR","CAP 1.5MG","30","Select","Select",""],["","62332003831","LAMOTRIGINE","TAB 100MG","120","Select","Select",""],["","60505265301","TRAZODONE","TAB 50MG","30","Select","Select",""],["","00023650110","UBRELVY","TAB 100MG","16","Select","Select",""],["","33342007007","OLANZAPINE","TAB 10MG","30","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00234057504","HIBICLENS","LIQ 0.04","118","Select","Select",""],["","45963055650","GABAPENTIN","300 MG","90","Select","Select",""],["","51759020210","AJOVY","INJ 225\/1.5","2","Select","Select",""],["","43547030303","ARIPIPRAZOLE","5 MG","30","Select","Select",""],["","00832712315","DIVALPROEX","TAB 250MG DR","60","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","51672302002","LIDOCAINE","OIN 0.05","30","Select","Select",""],["","66689000816","NYSTATIN","SUS 100000","200","Select","Select",""],["","43547027609","DONEPEZIL HCL","10 MG","30","Select","Select",""],["","23155050201","HYDROXYZINE HCL","50 MG","60","Select","Select",""],["","00406012505","HYDROCODONE-ACETAMINOPHEN","10MG-325MG","40","Select","Select",""],["","00378718505","METFORMIN HCL","500 MG","60","Select","Select",""],["","29300042301","AMITRIPTYLINE HCL","100 MG","30","Select","Select",""],["","68382010101","VENLAFAXINE HCL","100 MG","30","Select","Select",""],["","00378668877","PANTOPRAZOLE SODIUM","20 MG","90","Select","Select",""],["","69238208101","PROPRANOLOL HCL","80 MG","180","Select","Select",""],["","00832712315","DIVALPROEX SODIUM","250 MG","10","Select","Select",""],["","69584061110","METHOCARBAMOL","500 MG","90","Select","Select",""],["","10702000350","PROMETHAZINE HCL","25 MG","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":""}]}]}