{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AARON V CLARK","gend":0,"add":"335 CALHOUN ST APT D","city":"RICHMOND","state":"VA","zip":"23220-9998","dob":"1974-05-29","age":"","mstatus":"","insh":"2197318*01","cliId":"","pno":8042581768,"cno":8042581768,"email":"","ename":"","eno":"","pphy":"BONNER, LLOYD A MD","ppno":8043258801,"pcpadd":"STE 200 2401 W LEIGH ST,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23220-9998","pcpcounty":"","pcpid":"","pcpname":"Bon Secours Sports Medicine & Primary Care","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8042133051,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G89.18","M79.672","L91.0","M77.50","M96.0","M77.8","G57.92","G89.4","Z79.899","M79.2","NO DATA","M21.612","Z71.9","M20.42","Z01.812","Z20.822","M54.32","Z87.39","M54.42","M54.16","G89.29","D17.9","R22.2","M21.372","M77.42","G57.60","M54.5","M72.2","M77.52","Z01.818","N40.0","F41.9","F32.9","S33.5XXA","F17.200","M54.9","V58.89","T87.89","Z98.890","M89.8X7","T14.8XXA","M79.675","M79.676","L90.5","X50.0XXA","M21.962","F41.8","R73.02","Z87.891","G57.62","Z89.422","M24.572","S93.602A","R20.2"],"date":["2021-05-08","2023-07-05","2021-09-27","2021-09-27","2022-11-10","2022-11-10","2022-10-07","2023-04-25","2023-04-05","2023-04-05","2023-08-25","2021-07-27","2022-03-14","2022-05-27","2021-07-23","2021-07-23","2022-04-20","2022-04-20","2022-05-10","2022-05-10","2023-08-25","2022-06-02","2022-06-02","2022-11-10","2023-07-05","2023-02-13","2021-03-01","2021-05-19","2022-10-07","2021-06-30","2021-04-02","2023-08-25","2021-06-30","2022-03-14","2023-06-12","2022-03-14","2022-03-14","2023-04-25","2021-02-12","2021-02-12","2021-08-09","2022-11-10","2022-11-10","2021-12-22","2022-01-10","2022-11-02","2022-11-02","2022-11-02","2022-11-02","2023-01-04","2023-06-14","2023-07-05","2023-06-12","2023-06-12"],"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":[["","57664037708","TRAMADOL HCL","TAB 50MG","12","Select","Select",""],["","72888001405","CYCLOBENZAPR","TAB 10MG","10","Select","Select",""],["","00228202910","ALPRAZOLAM","0.5 MG","10","Select","Select",""],["","13668001101","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","29300034301","BACLOFEN","TAB 10MG","90","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","15","Select","Select",""],["","58602075521","PAIN RELIEF","TAB 500MG","24","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","65162079108","LIDOCAINE","PAD 0.05","8","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","15","Select","Select",""],["","65162074510","PROMETHAZINE","TAB 12.5MG","24","Select","Select",""],["","00093573101","OXYCODONE","TAB 10MG ER","15","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","42806031250","DOXYCYCL HYC","TAB 100MG","20","Select","Select",""],["","65162046550","IBUPROFEN","TAB 600MG","90","Select","Select",""],["","69238131309","PREGABALIN","CAP 100MG","60","Select","Select",""],["","16571020110","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","68382005101","MELOXICAM","TAB 15MG","30","Select","Select",""],["","13668001101","CITALOPRAM HBR","40 MG","30","Select","Select",""],["","00406051201","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","28","Select","Select",""],["","00406012301","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","10","Select","Select",""],["","00093216568","NALOXONE HCL","4 MG","2","Select","Select",""],["","57664037708","TRAMADOL HCL TAB","50MG","12","Select","Select",""],["","72888001405","CYCLOBENZAPR TAB","10MG","10","Select","Select",""],["","00228202910","ALPRAZOLAM TAB","0.5MG","20","Select","Select",""],["","13668001101","CITALOPRAM TAB","40MG","30","Select","Select",""],["","00406051201","OXYCOD\/APAP TAB","5-325MG","15","Select","Select",""],["","65162079108","LIDOCAINE PAD","5%","8","Select","Select",""],["","65162074510","PROMETHAZINE TAB","12.5MG","24","Select","Select",""],["","70010077001","METHOCARBAM TAB","750MG","15","Select","Select",""],["","68382005101","MELOXICAM TAB","15MG","30","Select","Select",""],["","00093573101","OXYCODONE TAB","10MG ER","15","Select","Select",""],["","29300034301","BACLOFEN TAB","10MG","90","Select","Select",""],["","00093031401","KETOROLAC TAB","10MG","15","Select","Select",""],["","58602075521","PAIN RELIEF TAB","500MG","24","Select","Select",""],["","42806040021","METHYLPRED TAB","4MG","21","Select","Select",""],["","42806031250","DOXYCYCL HYC TAB","100MG","20","Select","Select",""],["","69238131309","PREGABALIN CAP","100MG","60","Select","Select",""],["","16571020110","DICLOFENAC TAB","75MG DR","60","Select","Select",""],["","65162046550","IBUPROFEN TAB","600MG","90","Select","Select",""],["","00093506101","HYDROXYZINE HCL","25 MG","12","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","70010077001","METHOCARBAMOL","750 MG","28","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":""}]}]}