{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEVIN R BROWN","gend":0,"add":"4008 CHIPPENDALE DR","city":"RICHMOND","state":"VA","zip":"23234-9998","dob":"1977-05-15","age":"","mstatus":"","insh":"2187740*01","cliId":"","pno":8048779589,"cno":8048779589,"email":"","ename":"","eno":"","pphy":"RAZA, ZAHRA MD","ppno":8045274540,"pcpadd":"3470 MAYLAND COURT,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23233-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8045274487,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z20.828","Z04.9","G47.33","F31.31","R10.32","N13.2","N17.9","R65.10","T40.5X1A","J69.0","J96.01","U07.1","E87.2","F14.20","F31.30","I10.","E78.5","F17.210","R61.","Z56.0","R07.89","H92.03","R06.83","R06.81","G47.10","E66.9","T59.91XA","N20.1","N13.30","R10.31","R11.2","R07.9","Z53.29","N13.6","F17.200","Z20.822","R35.0","F41.9","F33.9","F31.81","R20.2","F52.21","F33.1","N39.0","F31.9","Z87.442","M94.261","R09.89","F41.1","F14.120","F12.20","R10.9","R41.82","F11.129","D12.0","D12.2","K64.8","Z12.11","Z23.","Z92.29","R57.9","J18.9","J80.","A41.9","F39.","F14.90","R65.21","G93.41","NO DATA","E87.6","D75.1","M62.82","T43.621A","R79.89","Z90.49"],"date":["2021-03-17","2021-06-14","2022-02-12","2022-06-11","2022-06-15","2022-10-01","2023-04-24","2022-06-15","2023-04-22","2023-04-22","2023-04-27","2022-09-20","2022-09-20","2023-04-12","2022-11-10","2023-04-22","2022-09-30","2023-04-22","2022-09-20","2022-09-20","2022-11-14","2021-04-15","2021-07-01","2021-06-08","2021-07-01","2021-07-01","2021-06-14","2022-10-04","2022-10-04","2022-11-14","2022-11-14","2022-11-14","2022-11-14","2022-06-15","2022-09-20","2022-09-30","2022-09-30","2021-12-21","2021-12-21","2021-12-21","2021-05-26","2021-05-26","2022-05-26","2022-06-18","2022-09-20","2022-10-04","2021-06-28","2021-03-23","2021-11-21","2021-11-21","2021-11-21","2022-06-15","2023-04-22","2022-09-20","2023-03-31","2023-03-31","2023-03-31","2023-03-31","2023-02-23","2023-02-23","2023-04-23","2023-04-27","2023-04-25","2023-04-27","2023-04-25","2023-04-25","2023-04-23","2023-04-27","2023-04-22","2023-04-22","2023-04-22","2023-04-22","2023-04-22","2023-04-22","2023-04-22"],"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":[["","00093310905","AMOXICILLIN","500 MG","21","Select","Select",""],["","67877019810","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","68180098103","LISINOPRIL","20 MG","90","Select","Select",""],["","16729018317","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","16729001016","PRAVASTATIN","TAB 40MG","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","68180044501","QUETIAPINE","TAB 25MG","30","Select","Select",""],["","42806066205","BUSPIRONE","TAB 5MG","60","Select","Select",""],["","65862019399","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","27241006903","SILDENAFIL","TAB 100MG","10","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","7","Select","Select",""],["","31722072250","LEVOFLOXACIN","TAB 500MG","5","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","12","Select","Select",""],["","69547035302","NARCAN","SPR 4MG","2","Select","Select",""],["","57896010410","ACETAMINOPHE","TAB 325MG","20","Select","Select",""],["","00093720298","PRAVASTATIN SODIUM","40 MG","90","Select","Select",""],["","43386009019","GAVILYTE-G","236-22.74G","4000","Select","Select",""],["","49483060350","IBUPROFEN","600 MG","21","Select","Select",""],["","42037010478","DEBROX","6.5 %","15","Select","Select",""],["","68180072003","AMLODIPINE BESYLATE","5 MG","30","Select","Select",""],["","50111033401","METRONIDAZOLE","500 MG","15","Select","Select",""],["","67877054360","CEFDINIR","300 MG","10","Select","Select",""],["","42806066205","BUSPIRONE TAB","5MG","60","Select","Select",""],["","68180044501","QUETIAPINE TAB","25MG","30","Select","Select",""],["","27241006903","SILDENAFIL TAB","100MG","10","Select","Select",""],["","10702001801","OXYCODONE TAB","5MG","12","Select","Select",""],["","57237001401","TAMSULOSIN CAP","0.4MG","30","Select","Select",""],["","33342002208","LEVOFLOXACIN TAB","500MG","5","Select","Select",""],["","57896010410","ACETAMINOPHE TAB","325MG","20","Select","Select",""],["","69547035302","NARCAN SPR","4MG","2","Select","Select",""],["","16729018317","HYDROCHLOROT TAB","25MG","30","Select","Select",""],["","00093720110","PRAVASTATIN TAB","20MG","60","Select","Select",""],["","67877019810","AMLODIPINE TAB","5MG","30","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":""}]}]}