{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"THOMAS BARTLETT","gend":0,"add":"9501 LUCY CORR CIR APT A","city":"CHESTERFIELD","state":"VA","zip":"23832-9998","dob":"1978-09-14","age":"","mstatus":"","insh":"20079827*01","cliId":"","pno":7137133789,"cno":7137133789,"email":"","ename":"","eno":"","pphy":"BHAT, SHRIDHAR V M D","ppno":8047802610,"pcpadd":"STE 304 110 N ROBINSON","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23220-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8046491041,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F22.","V62.85","Z02.2","F31.9","F31.2","F10.20","F12.20","F41.9","F39.","V62.84","F99.","I10.","J45.20","F17.210","Z71.6","R44.0","Z53.29","F29.","V58.69","Z91.128","F20.9","Z79.899","Z20.822","Z00.8","F33.2","T18.9XXA","NO DATA","J06.9","F17.200","Z86.73","R50.9","F25.0","R94.31","F11.20","T50.902A","F25.1","G47.00","R11.0","N52.9","F11.93","R60.0","F11.10","M79.89","F31.64","F60.9","J45.909","L08.9","F32.9","F10.10","F33.1","F11.23","H11.31","H10.11","M62.81","R53.81","F31.32","F31.60","K62.89","K64.9","F23.","Z74.3","F05.","R21.","F31.5","T14.91XA","F12.10","R05.9","R45.7","F31.70","F33.9","F14.10","M43.8X9","T43.592A","R53.83","E87.6","F12.90","Z91.14","R45.81"],"date":["2022-02-10","2022-02-10","2022-02-15","2022-06-26","2022-03-08","2022-07-01","2022-07-01","2022-04-06","2022-03-29","2022-06-17","2022-06-15","2022-06-21","2022-06-21","2022-06-26","2022-06-21","2022-02-09","2022-06-17","2022-06-04","2022-06-04","2022-06-04","2022-06-26","2022-06-04","2022-06-26","2022-06-04","2022-06-20","2022-06-17","2022-04-22","2022-04-26","2022-06-17","2022-04-26","2022-04-26","2022-06-15","2022-06-27","2022-05-23","2022-06-15","2022-07-01","2022-05-03","2022-05-03","2022-05-03","2022-05-03","2022-05-23","2022-05-23","2022-05-23","2022-06-15","2022-06-15","2022-06-15","2022-06-15","2022-06-16","2022-03-09","2022-03-21","2022-04-06","2022-04-22","2022-04-22","2022-05-03","2022-06-17","2022-05-19","2022-05-19","2022-06-13","2022-06-13","2022-06-15","2022-06-15","2022-02-15","2022-02-21","2022-03-15","2022-03-15","2022-03-15","2022-04-26","2022-04-27","2022-03-30","2022-06-26","2022-05-14","2022-06-17","2022-06-26","2022-06-26","2022-06-26","2022-02-10","2022-02-10","2022-05-10"],"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":[["","65862069790","VENLAFAXINE","CAP 150MG ER","30","Select","Select",""],["","62332010030","ARIPIPRAZOLE","TAB 15MG","60","Select","Select",""],["","69315013601","BENZTROPINE","TAB 0.5MG","60","Select","Select",""],["","00904530760","BANOPHEN","CAP 50MG","180","Select","Select",""],["","47781035703","BUPREN\/NALOX","MIS 8-2MG","60","Select","Select",""],["","16729018317","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","65862049101","QUETIAPINE","TAB 100MG","30","Select","Select",""],["","31722064630","TADALAFIL","TAB 20MG","15","Select","Select",""],["","00713050312","ANUCORT-HC","SUP 25MG","30","Select","Select",""],["","24385000605","ARTIFICIAL","SOL TEARS","15","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","2","Select","Select",""],["","68001023703","CLONIDINE","TAB 0.1MG","120","Select","Select",""],["","42806071501","BENZONATATE","CAP 200MG","20","Select","Select",""],["","00904198860","MAPAP","TAB 500MG","100","Select","Select",""],["","70074053984","PEDIALYTE","SOL STRAWBRY","1000","Select","Select",""],["","68382080505","TRAZODONE","TAB 50MG","30","Select","Select",""],["","17478006235","ARTIFI TEARS","OIN OP","4","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00904673060","ACETAMIN","TAB 500MG","100","Select","Select",""],["","00603533821","PREDNISONE","TAB 10MG","31","Select","Select",""],["","68001016208","PROMETHAZINE","TAB 25MG","60","Select","Select",""],["","45802034405","NICOTINE POL","LOZ 2MG MINT","30","Select","Select",""],["","42806016101","HYDROXYZ HCL","TAB 50MG","30","Select","Select",""],["","60505058604","OLOPATADINE","SOL 0.002","2","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":""}]}]}