{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANITRA DEVAUGHN","gend":1,"add":"1114 HICKORY ST","city":"RICHMOND","state":"VA","zip":"23220-9998","dob":"1978-06-23","age":"","mstatus":"","insh":"2103034*01","cliId":"","pno":8045131959,"cno":8045131959,"email":"","ename":"","eno":"","pphy":"AKAN-ETUK, UDUAK ETUN MD","ppno":8047800840,"pcpadd":"2809 N AVE STE 206,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23222-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8044201140,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I69.354","R51.9","E11.9","E11.59","Z79.4","N89.8","Z53.21","Z53.8","F31.30","F43.10","H47.393","Z72.0","Z79.899","Z83.511","R10.9","Z86.73","R11.2","N95.1","N94.10","R29.898","M79.672","NO DATA","D68.59","B00.9","J01.10","F06.31","F41.8","Z51.81","E55.9","D50.8","M79.89","N92.0","S50.812A","S50.12XA","R10.0","R10.31","N83.01","R73.09","R74.8","Z23.","M62.838","R05.9","R07.89","R07.9","G43.109","Y92.89","M79.605","Z87.891","R60.0","M79.606","R73.9","M79.609","K08.89","H91.93","Z01.411","Z11.51","N83.11","Z11.3","Z01.419","R53.1","M25.562","Z29.14","S81.851A","S80.211A","V58.89","A82.9","G24.9","I69.30","M54.18","H90.42"],"date":["2021-01-28","2021-01-28","2023-07-08","2023-08-23","2021-05-14","2023-09-18","2021-09-27","2021-09-27","2021-01-21","2021-01-21","2021-04-13","2021-04-13","2021-04-13","2021-04-13","2021-10-15","2021-10-15","2021-10-15","2023-09-18","2022-08-10","2022-09-14","2022-09-14","2023-08-24","2022-09-14","2023-09-18","2021-03-25","2023-08-24","2023-08-24","2023-08-24","2023-03-22","2023-01-19","2023-03-19","2023-09-18","2022-05-06","2022-05-06","2021-10-13","2021-10-13","2021-10-13","2021-01-04","2021-01-04","2023-07-08","2021-10-05","2021-12-31","2022-01-08","2022-01-08","2021-05-27","2022-05-06","2023-03-18","2023-03-18","2023-03-18","2021-05-04","2021-05-04","2021-05-04","2021-06-11","2021-06-11","2021-10-25","2021-10-25","2021-10-25","2021-10-25","2021-10-25","2023-04-14","2023-03-22","2023-07-08","2023-06-14","2023-06-14","2023-07-08","2023-06-24","2023-08-16","2023-08-16","2023-08-16","2023-08-31"],"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":[["","68180031909","BUPROPN HCL","TAB 150MG XL","30","Select","Select",""],["","50428046055","SLOW RELEASE","TAB 143MG","30","Select","Select",""],["","69452015120","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","50458057930","XARELTO","20 MG","30","Select","Select",""],["","00832712415","DIVALPROEX","TAB 500MG DR","60","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","400","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","00378395205","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","00603497528","OXYBUTYNIN","TAB 5MG","60","Select","Select",""],["","42806016105","HYDROXYZ HCL","TAB 50MG","60","Select","Select",""],["","67877024901","QUETIAPINE","TAB 50MG","30","Select","Select",""],["","00378427677","VALACYCLOVIR","1000 MG","4","Select","Select",""],["","00002879959","HUMALOG KWIK","INJ 100\/ML","6","Select","Select",""],["","23155022701","ACYCLOVIR","TAB 400MG","180","Select","Select",""],["","65862050320","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","08290320550","BD PEN NEEDL","MIS 32GX4MM","100","Select","Select",""],["","80777027399","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00002822259","INSULIN LISP","INJ 100\/ML","27","Select","Select",""],["","00002820705","LYUMJEV KWPN","INJ 100UT\/ML","9","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00121048905","DIPHENHYDRAM","ELX 12.5\/5ML","420","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","00591352530","LIDOCAINE","5 %","14","Select","Select",""],["","00067815202","VOLTAREN","GEL 0.01","50","Select","Select",""],["","69238110005","DOXYCYCL HYC","CAP 100MG","24","Select","Select",""],["","57896010410","ACETAMINOPHE","TAB 325MG","40","Select","Select",""],["","00113040378","PAIN RELIEF","TAB 325MG","120","Select","Select",""],["","69618001001","ACETAMIN","TAB 325MG","120","Select","Select",""],["","00713055550","DOXYCYC MONO","CAP 100MG","28","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","24","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","30","Select","Select",""],["","68180098003","LISINOPRIL","10 MG","30","Select","Select",""],["","86790001930","SLOW FE","142(45)MG","90","Select","Select",""],["","43547028910","BUPROPION","TAB 150MG SR","90","Select","Select",""],["","57237000930","MIRTAZAPINE","30 MG","30","Select","Select",""],["","53885004601","ONETOUCH ULTRA","2","1","Select","Select",""],["","08290320550","NANO","2ND GEN PEN NEEDLE 32GX 5\/32\"","100","Select","Select",""],["","00088221905","LANTUS SOLOSTAR","100\/ML (3)","15","Select","Select",""],["","43598083205","ATORVASTATIN CALCIUM","40 MG","90","Select","Select",""],["","68180031909","BUPROPION XL","150 MG","30","Select","Select",""],["","53885024510","ONETOUCH ULTRA TEST STRIP","","100","Select","Select",""],["","62756079813","DIVALPROEX SODIUM","500 MG","60","Select","Select",""],["","53885000810","ONETOUCH DELICA PLUS LANCET","33 GAUGE","100","Select","Select",""],["","69097052444","DICLOFENAC SODIUM","1 %","100","Select","Select",""],["","00054350049","LIDOCAINE HCL VISCOUS","2 %","100","Select","Select",""],["","57599080300","FREESTYLE LIBRE","2 READER","1","Select","Select",""],["","00378727253","NORETHINDRONE","0.35 MG","84","Select","Select",""],["","68462012605","GABAPENTIN","600 MG","90","Select","Select",""],["","45802009735","ESTRADIOL","0.01 %","42.5","Select","Select",""],["","00591352530","LIDOCAINE PAD","5%","30","Select","Select",""],["","50458057930","XARELTO TAB","20MG","90","Select","Select",""],["","00088221905","LANTUS SOLOS INJ","100\/ML","15","Select","Select",""],["","08290320550","BD PEN NEEDL MIS","32GX4MM","100","Select","Select",""],["","68180098003","LISINOPRIL TAB","10MG","30","Select","Select",""],["","86790001960","SLOW FE TAB","45MG","30","Select","Select",""],["","00378395205","ATORVASTATIN TAB","40MG","90","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","4","Select","Select",""],["","00832712415","DIVALPROEX TAB","500MG DR","60","Select","Select",""],["","68180031909","BUPROPN HCL TAB","150MG XL","90","Select","Select",""],["","13107000130","MIRTAZAPINE TAB","7.5MG","30","Select","Select",""],["","43547028910","BUPROPION TAB","150MG SR","60","Select","Select",""],["","73070010315","INSULIN ASPART FLEXPEN","100\/ML (3)","15","Select","Select",""],["","66685100100","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","8","Select","Select",""],["","12870000101","SILVER NITRATE APPLICATOR","75 %-25 %","20","Select","Select",""],["","70010075401","METHOCARBAMOL","500 MG","30","Select","Select",""],["","23155050201","HYDROXYZINE HCL","50 MG","60","Select","Select",""],["","08508300021","OMNIPOD","5 G6 PODS (GEN 5)","5","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":""}]}]}