{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TIMOTHY HAIR","gend":0,"add":"8900 BANNON ROAD","city":"RICHMOND","state":"VA","zip":"23235-9998","dob":"1962-06-05","age":"","mstatus":"","insh":"2166839*01","cliId":"","pno":8044056475,"cno":8044056475,"email":"","ename":"","eno":"","pphy":"BLEVINS, CAROLINE MD","ppno":8045600490,"pcpadd":"500 HIOAKS ROAD SUITE B,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23225-9998","pcpcounty":"","pcpid":"","pcpname":"Primary Health Group - Chippenham","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8045603424,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D47.1","I73.9","I70.219","C61.","I70.211","I48.0","NO DATA","C95.90","J44.9","Z72.0","Z79.899","Z68.24","R97.20","N42.9","R35.1","I70.291","M79.605","Z79.01","Z87.891","Z23.","Z71.85","I48.91","Z79.52","I70.201","Z01.818","K21.9","N15.9","L30.8","L82.1","Z12.11","D12.5","K57.30","F17.210","M19.90","J45.909","Z86.010","Z85.6","N43.3","Z51.11","M79.609","R07.89","S61.232A","M13.0","Z68.25","T63.441S","R22.32","Z79.818","E53.8","Z00.00","C77.5","Z20.822","J40.","R49.0","J38.01","M79.604","R74.8","R79.89","Z13.220","Z09.","E66.3","Z71.3","Z68.26","K63.5","Z12.2","J43.8","S60.221A","S60.416A","S63.501A","M79.644","E55.9","G62.9"],"date":["2023-03-01","2023-06-16","2023-02-07","2023-06-16","2023-02-25","2023-03-13","2023-06-16","2023-06-16","2023-06-16","2022-12-16","2023-02-23","2022-12-16","2022-05-10","2022-07-12","2022-08-16","2022-08-17","2022-08-17","2023-03-13","2023-03-13","2022-10-13","2022-10-13","2023-02-23","2023-01-30","2023-02-23","2023-02-07","2023-02-23","2023-02-23","2021-12-06","2021-12-06","2022-04-08","2022-04-08","2022-04-08","2022-04-08","2022-04-08","2022-04-08","2022-04-08","2022-04-08","2022-05-18","2022-12-08","2022-08-17","2021-06-09","2021-06-09","2021-06-09","2023-06-16","2021-06-09","2021-06-09","2022-08-16","2022-12-16","2022-12-16","2022-04-29","2022-10-29","2022-10-29","2022-11-04","2022-11-04","2023-01-13","2022-06-08","2022-06-08","2022-06-08","2023-03-14","2023-06-16","2023-06-16","2023-03-14","2022-04-08","2021-11-10","2021-11-10","2023-05-31","2023-05-31","2023-05-31","2023-05-31","2023-06-16","2023-06-16"],"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":[["","55111046601","METOPROL SUC","TAB 25MG ER","30","Select","Select",""],["","49884072401","HYDROXYUREA","500 MG","36","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","29300035916","AMIODARONE","TAB 200MG","30","Select","Select",""],["","50458057830","XARELTO","15 MG","30","Select","Select",""],["","68645056054","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","65162062710","TRAMADOL HCL","TAB 50MG","18","Select","Select",""],["","50111056003","TRAZODONE","TAB 50MG","30","Select","Select",""],["","00173086910","ANORO ELLIPT","AER 62.5-25","180","Select","Select",""],["","80777027310","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","90","Select","Select",""],["","00093598627","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","45802005505","TRIAMCINOLON","OIN 0.001","454","Select","Select",""],["","00536116401","ACETAMIN","TAB 325MG","30","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","6","Select","Select",""],["","50580049698","TYLENOL","TAB 325MG","30","Select","Select",""],["","69452017173","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","70461042110","FLUCLVX QUAD","INJ 2021-22","0","Select","Select",""],["","52268001201","SUPREP BOWEL","SOL PREP KIT","354","Select","Select",""],["","64380076921","PEG-3350\/KCL","SOL \/SODIUM","4000","Select","Select",""],["","67877054360","CEFDINIR","CAP 300MG","6","Select","Select",""],["","68382013210","TAMSULOSIN","CAP 0.4MG","3","Select","Select",""],["","69315012710","FOLIC ACID","TAB 1000MCG","30","Select","Select",""],["","00143980305","DOXYCYCL HYC","CAP 100MG","6","Select","Select",""],["","60505476406","ABIRATERONE","TAB 500MG","60","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","6","Select","Select",""],["","59746017206","PREDNISONE","5 MG","60","Select","Select",""],["","60219204301","DEXAMETHASON","TAB 4MG","8","Select","Select",""],["","0","COMPOUND","","240","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","30","Select","Select",""],["","16714016001","ONDANSETRON","TAB 8MG","30","Select","Select",""],["","42571016242","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","55111046601","METOPROLOL SUCCINATE","25 MG","30","Select","Select",""],["","72888003960","AMIODARONE HCL","200 MG","30","Select","Select",""],["","00173086910","ANORO ELLIPTA","62.5-25MCG","60","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","16571040250","CETIRIZINE HCL","10 MG","30","Select","Select",""],["","13668033005","TRAZODONE HCL","50 MG","30","Select","Select",""],["","42571016242","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","20","Select","Select",""],["","80777028205","MODERNA COVID BIVAL (","6Y UP)EUA 50 MCG\/0.5","0.5","Select","Select",""],["","60505476406","ABIRATERONE ACETATE","500 MG","60","Select","Select",""],["","00406051205","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","20","Select","Select",""],["","58160082311","SHINGRIX","50 MCG\/0.5","1","Select","Select",""],["","60505082901","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","00536116401","ACETAMIN TAB","325MG","30","Select","Select",""],["","55111046601","METOPROL SUC TAB","25MG ER","30","Select","Select",""],["","49884072401","HYDROXYUREA CAP","500MG","36","Select","Select",""],["","29300035916","AMIODARONE TAB","200MG","30","Select","Select",""],["","16571040250","CETIRIZINE TAB","10MG","30","Select","Select",""],["","50111056003","TRAZODONE TAB","50MG","30","Select","Select",""],["","00093317431","ALBUTEROL AER HFA","","8","Select","Select",""],["","50458057830","XARELTO TAB","15MG","30","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","68645056054","MONTELUKAST TAB","10MG","90","Select","Select",""],["","52268001201","SUPREP BOWEL SOL PREP KIT","","354","Select","Select",""],["","00093598627","EPINEPHRINE INJ","0.3MG","2","Select","Select",""],["","00173086910","ANORO ELLIPT AER","62.5-25","180","Select","Select",""],["","64380076921","PEG-","3350\/KCL SOL \/SODIUM","4000","Select","Select",""],["","00143992801","CIPROFLOXACN TAB","500MG","6","Select","Select",""],["","69315012710","FOLIC ACID TAB","1000MCG","30","Select","Select",""],["","67877054360","CEFDINIR CAP","300MG","6","Select","Select",""],["","68382013210","TAMSULOSIN CAP","0.4MG","3","Select","Select",""],["","00143980305","DOXYCYCL HYC CAP","100MG","6","Select","Select",""],["","45802005505","TRIAMCINOLON OIN","0.1%","454","Select","Select",""],["","50383070016","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","16714016001","ONDANSETRON TAB","8MG","30","Select","Select",""],["","59746017206","PREDNISONE TAB","5MG","60","Select","Select",""],["","60505476406","ABIRATERONE TAB","500MG","60","Select","Select",""],["","60219204301","DEXAMETHASON TAB","4MG","8","Select","Select",""],["","59746011506","PROCHLORPER TAB","10MG","30","Select","Select",""],["","76204020025","ALBUTEROL NEB","0.083%","75","Select","Select",""],["","42571016242","AMOX\/K CLAV TAB","875-125","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":""}]}]}