{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHARON L LANE","gend":1,"add":"903 GLIDEWELL ROAD","city":"RICHMOND","state":"VA","zip":"23227-9998","dob":"1971-05-10","age":"","mstatus":"","insh":"20080600*01","cliId":"","pno":8046475703,"cno":8046475703,"email":"","ename":"","eno":"","pphy":"RIEDT, STACY NP","ppno":8048830046,"pcpadd":"15078 BROWN PLEASANTS ROAD","pcpcity":"MONTPELIER","pcpstate":"VA","pcpzip":"23192-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048830048,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z12.11","K57.90","K64.9","E66.01","D22.9","L57.0","D47.2","Z80.0","K57.30","N85.02","E66.9","R51.9","R42.","Z68.42","G47.33","L92.0","L72.0","M35.9","L50.1","E55.9","M89.8X9","M17.12","G89.4","H92.02","NO DATA","R07.89","M79.7","F41.9","F32.9","M47.816","M70.62","L50.8","L25.9","M32.9","R06.02","U07.1","Z20.822","R50.9","L08.9","B96.89","R94.31","E11.9","E78.00","M19.90","Z79.52","Z79.899","Z85.42","Z90.49","R21.","B95.8","R07.9","H90.3","L30.4","L23.89","L29.9","L24.7","B37.0","J06.9","R07.0","R19.7","R11.0","F17.210","R53.83","I10.","M35.1","M25.522","M25.562","T78.40XA","R00.1","Z72.0","Z71.6","G47.30","Z71.9","R10.11","R07.81","R10.9","K92.1","R11.2","R10.2","R73.03","F33.9","I49.3","K21.9","R19.4","K62.5"],"date":["2022-03-16","2022-03-16","2022-03-16","2023-05-03","2022-10-12","2022-10-12","2023-05-03","2022-03-16","2023-04-26","2023-01-24","2023-01-24","2022-09-16","2022-09-23","2023-05-03","2022-05-18","2022-07-14","2022-07-14","2023-05-03","2023-04-24","2023-02-13","2023-02-13","2023-02-13","2022-02-07","2022-02-14","2023-05-03","2022-06-08","2022-09-14","2022-06-29","2022-06-29","2022-08-12","2022-08-12","2022-09-14","2022-09-10","2022-09-10","2023-04-24","2022-01-02","2022-09-25","2022-01-07","2022-09-08","2022-05-02","2022-06-08","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-08","2022-09-11","2022-02-14","2022-05-10","2022-05-10","2022-05-10","2022-09-14","2022-09-14","2022-09-25","2022-09-25","2023-04-26","2022-09-25","2022-01-07","2023-05-03","2022-05-18","2022-05-18","2022-07-18","2022-07-18","2023-02-27","2023-04-24","2023-04-24","2023-04-20","2023-04-24","2023-04-24","2023-03-21","2023-03-21","2023-03-21","2023-04-26","2023-05-05","2023-04-26","2023-05-03","2023-05-03","2023-05-03","2023-05-05","2023-05-05","2023-05-05"],"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":[["","00378064205","PREDNISONE","20 MG","6","Select","Select",""],["","42806031250","DOXYCYCL HYC","TAB 100MG","14","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","69097083512","SERTRALINE","TAB 100MG","30","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","4","Select","Select",""],["","64380076921","PEG-3350\/KCL","SOL \/SODIUM","4000","Select","Select",""],["","43598072101","HYDROXYCHLOR","TAB 200MG","60","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA","100","Select","Select",""],["","50428085942","PREP PADS","PAD ","100","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","00002143380","TRULICITY","0.75MG\/0.5","2","Select","Select",""],["","33342032915","TRIAMCINOLON","CRE 0.001","45","Select","Select",""],["","53885001110","ONETOUCH DEL","MIS PLUS 30G","100","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","30","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","45802011222","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","51672128902","NYSTATIN","CRE 100000","30","Select","Select",""],["","42806016005","HYDROXYZ HCL","TAB 25MG","30","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","00054414622","CLOTRIMAZOLE","TRO 10MG","40","Select","Select",""],["","62332014131","CELECOXIB","100 MG","60","Select","Select",""],["","16571020111","DICLOFENAC SODIUM","75 MG","60","Select","Select",""],["","53885024450","ONETOUCH ULTRA TEST STRIP","","50","Select","Select",""],["","65862001205","SERTRALINE HCL","50 MG","270","Select","Select",""],["","43598072101","HYDROXYCHLOROQUINE SULFATE","200 MG","60","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","13668042905","PANTOPRAZOLE SODIUM","40 MG","30","Select","Select",""],["","68462010530","ONDANSETRON HCL","4 MG","20","Select","Select",""],["","62559049010","DIPHENOXYLATE-ATROPINE","2.5-.025MG","20","Select","Select",""],["","00143312601","DICYCLOMINE HCL","10 MG","10","Select","Select",""],["","00173086910","ANORO ELLIPTA","62.5-25MCG","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":""}]}]}