{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRANDON C INSCOE","gend":1,"add":"5749 COGBILL ROAD","city":"RICHMOND","state":"VA","zip":"23234-9998","dob":"1969-11-28","age":"","mstatus":"","insh":"20083666*01","cliId":"","pno":8049082873,"cno":8049082873,"email":"","ename":"","eno":"","pphy":"LIENG, THANH-TRUC T MD","ppno":8042769305,"pcpadd":"2500 POCOSHOCK PLACE STE 4,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23235-9998","pcpcounty":"","pcpid":"","pcpname":"VPI - Innsbrook Primary Care","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8042768324,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E10.621","L97.529","L97.519","N17.9","E10.65","E87.1","N39.0","F19.90","Z91.14","Z88.0","Z88.2","G47.33","R07.9","E11.65","R20.0","A41.51","NO DATA","Z20.822","Z79.4","M54.9","R11.0","R39.15","Z79.899","E83.39","A41.9","L03.211","F15.10","E10.9","Z72.0","I62.9","L02.811","F29.","E11.40","R11.2","R00.0","E86.1","W18.30XA","R73.9","R30.0","L98.499","I62.03","E10.40","Z86.14","Z79.84","F17.210","L21.0","R22.0","E83.42","E83.52","E86.0","E13.43","R78.81","E87.6","R60.9","T78.3XXA","I25.2","I95.9","R53.1","L98.9","M54.2","M25.552"],"date":["2022-10-19","2022-10-19","2022-10-19","2023-01-07","2022-10-19","2022-10-20","2023-02-27","2022-10-20","2022-10-19","2023-01-07","2023-01-07","2022-10-19","2023-02-27","2023-02-27","2023-02-27","2022-09-03","2023-01-09","2022-09-03","2023-01-07","2022-09-03","2022-09-03","2022-09-03","2023-01-07","2022-09-05","2023-01-09","2023-01-09","2023-01-09","2023-01-09","2023-01-09","2023-01-09","2023-01-09","2023-01-09","2023-01-09","2022-06-04","2023-02-08","2022-09-03","2022-06-02","2023-02-08","2022-09-03","2022-10-20","2023-01-07","2023-01-07","2023-01-07","2023-01-07","2023-01-07","2023-01-07","2023-01-07","2022-09-05","2022-09-05","2022-09-03","2022-06-04","2022-09-05","2022-09-05","2023-01-07","2023-01-07","2022-06-02","2022-06-02","2022-06-02","2022-10-19","2023-02-08","2023-02-08"],"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":[["","00832532411","POT CL MICRO","TAB 10MEQ ER","60","Select","Select",""],["","62332002431","FLUOXETINE","CAP 40MG","90","Select","Select",""],["","00536105224","PEG3350","POW ","238","Select","Select",""],["","50228017705","GABAPENTIN","TAB 600MG","60","Select","Select",""],["","64980010401","PHOSPHA 250","TAB NEUTRAL","6","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","00093100301","BUSPIRONE","TAB 15MG","30","Select","Select",""],["","23155050110","HYDROXYZ HCL","TAB 25MG","30","Select","Select",""],["","65862000899","METFORMIN","TAB 500MG","180","Select","Select",""],["","98302013919","INSULIN SYRG","MIS 1ML\/31G","100","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","100","Select","Select",""],["","00093101042","MUPIROCIN","2 %","22","Select","Select",""],["","53885004401","ONE TOUCH","KIT VERIO FL","1","Select","Select",""],["","00002871501","HUMULIN","70-30 70-30\/ML","10","Select","Select",""],["","00143211205","DOXYCYCL HYC","TAB 100MG","14","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","50","Select","Select",""],["","68645058259","METFORMIN HCL","500 MG","30","Select","Select",""],["","43386035610","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","10","Select","Select",""],["","65862007701","CIPROFLOXACIN HCL","500 MG","14","Select","Select",""],["","23155013525","DOXYCYCLINE MONOHYDRATE","100 MG","14","Select","Select",""],["","67877024201","QUETIAPINE FUMARATE","25 MG","30","Select","Select",""],["","51672200306","CLOTRIMAZOLE","1 %","45","Select","Select",""],["","62332002431","FLUOXETINE CAP","40MG","90","Select","Select",""],["","00093100301","BUSPIRONE TAB","15MG","30","Select","Select",""],["","65862052305","GABAPENTIN TAB","600MG","30","Select","Select",""],["","00832532411","POT CL MICRO TAB","10MEQ ER","60","Select","Select",""],["","64980010401","PHOSPHA","250 TAB NEUTRAL","6","Select","Select",""],["","65862007701","CIPROFLOXACN TAB","500MG","20","Select","Select",""],["","00002871501","HUMULIN INJ","70\/30","10","Select","Select",""],["","53885004401","ONE TOUCH KIT VERIO FL","","1","Select","Select",""],["","57237000511","FLUCONAZOLE TAB","150MG","1","Select","Select",""],["","51672131200","MUPIROCIN OIN","2%","22","Select","Select",""],["","53885000810","ONETOUCH DEL MIS PLUS","33G","100","Select","Select",""],["","53885027150","ONETOUCH TES VERIO","","50","Select","Select",""],["","98302013919","INSULIN SYRG MIS","1ML\/31G","100","Select","Select",""],["","00536105224","PEG","3350 POW","238","Select","Select",""],["","00143211205","DOXYCYCL HYC TAB","100MG","14","Select","Select",""],["","23155050110","HYDROXYZ HCL TAB","25MG","30","Select","Select",""],["","65862000899","METFORMIN TAB","500MG","180","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":""}]}]}