{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VERDELL L JONES","gend":1,"add":"4237 LAMPLIGHTER CT","city":"RICHMOND","state":"VA","zip":"23224-9998","dob":"1967-02-24","age":"","mstatus":"","insh":"2322804*01","cliId":"","pno":8044374152,"cno":8044374152,"email":"","ename":"","eno":"","pphy":"JIMA, BOGALE MD","ppno":8042766900,"pcpadd":"10130 HULL STREET,","pcpcity":"MIDLOTHIAN","pcpstate":"VA","pcpzip":"23112-9998","pcpcounty":"","pcpid":"","pcpname":"Primary Health Group - Johnston-Willis","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8042761366,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M17.12","S83.242A","S83.282A","I10.","Z87.891","Z20.828","Z20.822","H81.10","H83.09","J45.41","H90.3","H61.22","Z53.21","Z09.","I63.9","E11.9","E78.2","E55.9","D72.829","H93.13","M25.511","R94.31","G45.9","R42.","J40.","R51.9","E78.5","I67.2","H93.19","M19.90","Z79.1","Z79.51","Z79.52","Z79.82","Z79.84","Z79.899","I65.03","Z86.73","I69.351","I65.01","I65.02","U07.1","G47.33","G47.36","R73.03","R07.9","E66.01","I25.10","Z68.41","M79.671","M25.562","M72.2","NO DATA","Z68.42","R29.701","E66.9","R26.2","R47.81","I63.50","R11.0","R06.2","Z04.9","M25.561","M17.10","M81.0","I69.398","R03.0","I95.9","I77.1","Z79.02","Z98.51","Z28.311","J10.1","G89.18","J01.10","M23.204","J20.9","J45.901","J34.89","R09.82","Z71.1","R53.83","H53.2","I51.7","Z01.818","J30.9","R91.1","J18.9","R29.898","H93.12","J45.998","M75.31","F17.200","R20.0","G89.29","M79.604","M79.605","F17.210","Z71.3","M75.91","D64.9","E46.","E53.9","Z13.1","Z12.2"],"date":["2023-08-29","2021-01-08","2021-01-08","2023-05-24","2023-04-21","2021-10-07","2022-10-11","2022-01-31","2022-02-15","2022-02-15","2022-02-15","2022-02-15","2022-03-06","2022-08-16","2023-06-16","2023-04-21","2023-03-06","2023-03-07","2023-06-02","2022-06-30","2022-07-01","2022-07-31","2023-05-24","2022-07-27","2022-07-27","2023-04-21","2023-02-21","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2022-07-27","2023-04-21","2023-04-21","2022-07-27","2023-03-06","2023-04-21","2022-07-27","2022-07-27","2022-07-27","2022-11-25","2023-03-01","2023-03-01","2023-05-24","2023-03-06","2023-06-16","2023-05-24","2023-05-24","2022-03-30","2023-04-18","2022-03-30","2023-02-21","2022-06-01","2022-06-01","2022-10-11","2022-06-01","2022-06-01","2022-06-03","2022-02-09","2022-02-09","2022-03-06","2022-04-29","2022-04-29","2023-08-29","2022-06-17","2022-07-11","2022-10-11","2022-10-11","2022-10-11","2022-10-11","2022-10-11","2022-12-01","2021-01-08","2021-10-07","2023-08-29","2021-11-11","2021-11-11","2021-11-11","2021-11-11","2022-01-18","2023-03-07","2023-04-21","2022-07-31","2023-05-23","2023-05-23","2023-05-23","2022-01-04","2022-06-03","2022-07-10","2022-07-12","2022-04-08","2022-04-08","2022-04-08","2023-02-21","2023-02-21","2023-02-21","2021-11-01","2021-11-01","2022-04-08","2023-03-07","2023-03-07","2023-03-07","2023-03-07","2023-04-21"],"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":[["","16729000617","SIMVASTATIN","TAB 40MG","90","Select","Select",""],["","65862064169","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","32","Select","Select",""],["","70954005820","PREDNISONE","TAB 5MG","25","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","65862001705","AMOXICILLIN","CAP 500MG","60","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","52536013301","MECLIZINE","TAB 25MG","30","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","00172392570","DIAZEPAM","TAB 2MG","10","Select","Select",""],["","00781185220","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","70010049105","METFORMIN","TAB 500MG ER","180","Select","Select",""],["","00378113401","KETOROLAC","TAB 10MG","10","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","60","Select","Select",""],["","53885099425","ONETOUCH","TES ULTRA","25","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","28","Select","Select",""],["","00363041414","ASPIRIN","TAB 81MG EC","90","Select","Select",""],["","00781569031","EZETIMIBE","10 MG","90","Select","Select",""],["","00363058714","ASPIRIN 81","TAB 81MG EC","30","Select","Select",""],["","65862020399","LOSARTAN POT","TAB 100MG","90","Select","Select",""],["","56151146001","TRUE METRIX","TES GLUCOSE","100","Select","Select",""],["","31722052001","HYDRALAZINE","TAB 25MG","270","Select","Select",""],["","65862035705","CLOPIDOGREL","75 MG","30","Select","Select",""],["","55111012405","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","53885001110","ONETOUCH DEL","MIS PLUS 30G","100","Select","Select",""],["","00904678370","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","00363237102","LANCETS MICR","MIS THIN 33G","100","Select","Select",""],["","64380079901","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","15","Select","Select",""],["","65162062750","TRAMADOL HCL","50 MG","21","Select","Select",""],["","60505082901","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","29300012810","HYDROCHLOROTHIAZIDE","25 MG","30","Select","Select",""],["","31722072690","MONTELUKAST SODIUM","10 MG","30","Select","Select",""],["","00904678370","ASPIRIN EC","81 MG","30","Select","Select",""],["","65862020399","LOSARTAN POTASSIUM","100 MG","90","Select","Select",""],["","70010049105","METFORMIN HCL ER","500 MG","60","Select","Select",""],["","00406055201","OXYCODONE HCL","5 MG","2","Select","Select",""],["","43598083305","ATORVASTATIN CALCIUM","80 MG","90","Select","Select",""],["","00406012405","HYDROCODONE-ACETAMINOPHEN","7.5-325 MG","6","Select","Select",""],["","10702025350","BUTALBITAL-ACETAMINOPHEN-CAFFE","50-325-40","15","Select","Select",""],["","69097052444","DICLOFENAC SODIUM","1 %","300","Select","Select",""],["","00169418113","OZEMPIC .","25 OR 0.5","3","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":""}]}]}