{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"REBECCA  L MULLENBROCK","gend":1,"add":"1117 ADKINS ROAD","city":"RICHMOND","state":"VA","zip":"23236-9998","dob":"1992-01-10","age":"","mstatus":"","insh":"2094973*01","cliId":"","pno":8042533077,"cno":8042533077,"email":"","ename":"","eno":"","pphy":"MCCURLEY, JOHN M MD","ppno":8048289357,"pcpadd":"417 N 11TH STREET,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23298-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048287591,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R10.9","S90.31XA","U07.1","I95.1","K21.9","E66.01","I10.","Z79.899","Z68.44","R07.9","R07.89","R42.","I49.9","M54.9","R06.9","Z20.822","Z11.59","R20.0","N39.0","N20.0","R20.2","R31.9","F43.12","F41.1","F31.81","M79.671","R09.02","R06.89","R00.0","Z23.","Z68.43","R11.0","I49.8","G93.2","Z88.1","Z88.5","K29.70","NO DATA","J06.9","S93.401A","Y93.K1","M25.561","H47.11","H04.123","R10.814","R06.02","R11.2","H57.12","L03.115","E66.9","M79.89","Z20.828","S39.012A","Z87.828","E28.2","N30.90","R10.32","Z03.818","M25.461","R06.83","G43.909","Z01.818","J30.2","Z13.9","E55.9","Z71.3","Z01.419","N92.6","Z11.3","R94.31","R51.9"],"date":["2021-04-28","2021-05-04","2022-01-24","2022-01-22","2022-10-27","2023-05-04","2023-07-10","2022-01-24","2023-05-04","2022-01-24","2022-01-24","2023-07-10","2022-01-24","2022-01-24","2022-01-24","2022-04-15","2022-04-15","2022-08-16","2023-07-10","2022-10-27","2023-07-10","2022-08-16","2023-06-17","2023-06-07","2023-06-07","2022-05-25","2022-01-24","2022-01-24","2022-01-24","2022-05-05","2023-05-02","2022-10-27","2023-07-10","2023-05-04","2022-01-24","2022-01-24","2022-03-30","2023-03-28","2021-09-30","2021-10-21","2021-10-21","2022-04-01","2023-02-17","2023-02-17","2021-09-21","2022-01-18","2022-08-13","2022-03-11","2023-02-08","2023-02-08","2023-02-08","2021-03-11","2022-01-17","2022-02-16","2023-05-04","2022-08-13","2021-09-21","2021-09-30","2022-02-16","2022-03-23","2022-03-23","2022-03-30","2023-03-28","2023-03-28","2023-05-04","2023-04-06","2023-04-24","2023-04-24","2023-04-24","2023-07-10","2023-07-10"],"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":[["","52268001201","SUPREP BOWEL","SOL PREP KIT","354","Select","Select",""],["","60846050201","PYRIDIUM","TAB 200MG","6","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","51293061201","PHENAZOPYRID","TAB 200MG","6","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","7","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","90","Select","Select",""],["","00378113401","KETOROLAC","TAB 10MG","10","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","64380071206","BENZONATATE","CAP 100MG","30","Select","Select",""],["","42806016005","HYDROXYZ HCL","TAB 25MG","60","Select","Select",""],["","31722053401","METHOCARBAM","TAB 750MG","20","Select","Select",""],["","52536013301","MECLIZINE","TAB 25MG","20","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","28","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00093005805","TRAMADOL HCL","TAB 50MG","14","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","69452015120","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","15","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","90","Select","Select",""],["","13668004701","LAMOTRIGINE","100 MG","90","Select","Select",""],["","70954002110","PRAZOSIN HCL","5 MG","90","Select","Select",""],["","42806016005","HYDROXYZINE HCL","25 MG","60","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","14","Select","Select",""],["","00168002031","HYDROCORTISONE","1 %","28.35","Select","Select",""],["","53489011905","DOXYCYCLINE HYCLATE","100 MG","14","Select","Select",""],["","31722053401","METHOCARBAM TAB","750MG","20","Select","Select",""],["","65862039010","ONDANSETRON TAB","4MG ODT","20","Select","Select",""],["","64380071206","BENZONATATE CAP","100MG","30","Select","Select",""],["","00378113401","KETOROLAC TAB","10MG","10","Select","Select",""],["","42806016005","HYDROXYZ HCL TAB","25MG","60","Select","Select",""],["","50228043605","NAPROXEN TAB","500MG","20","Select","Select",""],["","52536013301","MECLIZINE TAB","25MG","20","Select","Select",""],["","59746000103","METHYLPRED TAB","4MG","21","Select","Select",""],["","00093005805","TRAMADOL HCL TAB","50MG","14","Select","Select",""],["","16571020106","DICLOFENAC TAB","75MG DR","28","Select","Select",""],["","00378668910","PANTOPRAZOLE TAB","40MG","30","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","4","Select","Select",""],["","00093310905","AMOXICILLIN CAP","500MG","15","Select","Select",""],["","13811071910","NITROFURANTN CAP","100MG","10","Select","Select",""],["","57237002801","AMOXICILLIN TAB","500MG","20","Select","Select",""],["","50111056001","TRAZODONE TAB","50MG","90","Select","Select",""],["","13668004501","LAMOTRIGINE TAB","25MG","90","Select","Select",""],["","70954002110","PRAZOSIN HCL CAP","5MG","30","Select","Select",""],["","47781030301","NITROFURANTOIN MONO-MACRO","100 MG","10","Select","Select",""],["","00093117210","PENICILLIN V POTASSIUM","250 MG","15","Select","Select",""],["","44523074301","USTELL","120-0.12MG","30","Select","Select",""],["","42858030101","HYDROMORPHONE HCL","2 MG","20","Select","Select",""],["","00093031401","KETOROLAC TROMETHAMINE","10 MG","20","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":""}]}]}