{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RACHEL  N ISNER","gend":1,"add":"4300 WARWICK ROAD","city":"RICHMOND","state":"VA","zip":"23234-9998","dob":"1981-11-17","age":"","mstatus":"","insh":"2357176*01","cliId":"","pno":4405525958,"cno":4405525958,"email":"","ename":"","eno":"","pphy":"BALMER, LUKE NP","ppno":8048289205,"pcpadd":"417 N 11TH ST","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23298-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048286082,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E31.0","K58.9","R07.9","I21.4","I25.10","E10.10","E10.22","I12.9","N17.9","N18.2","E87.1","E03.9","G89.29","Z79.4","G89.4","M47.817","M51.26","L03.031","E10.9","E87.6","R94.31","M79.2","E78.5","R60.0","L98.8","R58.","T45.525A","I10.","M54.16","I24.8","E87.5","R77.8","Z79.891","NO DATA","I25.2","D51.0","E10.649","E83.39","E05.90","R00.0","I95.9","F41.9","E11.610","F32.9","M79.7","E66.9","Z20.822","K58.0","D63.1","K90.0","F10.10","D64.9","Z68.33","T84.038A","S82.90XA","E11.8","S61.402A","E11.9","I20.9","R06.03","R11.2","I11.0","I50.30","R00.1","R07.89","Z79.899","Z51.81","E10.65","E55.9","Z74.3","Z96.41","M25.571","M54.5","E11.10","E87.2","R79.89"],"date":["2021-01-20","2021-04-07","2023-01-11","2023-01-11","2023-01-09","2023-01-11","2023-01-09","2023-01-09","2023-01-11","2021-06-21","2021-06-21","2023-01-11","2021-06-21","2021-06-21","2023-03-22","2023-02-17","2023-03-22","2021-06-03","2021-07-27","2021-06-18","2023-01-10","2023-01-06","2022-01-13","2021-08-19","2021-08-19","2021-08-19","2021-08-19","2023-01-11","2023-03-22","2023-01-11","2023-01-11","2023-01-11","2022-05-25","2023-01-09","2023-01-09","2023-01-09","2023-01-09","2023-01-09","2023-01-09","2023-01-10","2023-01-09","2023-01-09","2021-01-22","2021-06-17","2021-06-17","2021-07-06","2021-06-17","2021-06-17","2021-06-17","2021-06-17","2021-06-17","2021-06-21","2021-07-06","2021-07-16","2021-07-16","2022-05-13","2021-05-27","2021-05-27","2021-06-16","2021-06-16","2021-06-16","2022-01-13","2022-01-13","2022-01-13","2022-01-13","2022-01-13","2022-08-01","2021-12-22","2021-12-22","2023-01-09","2021-07-27","2021-06-17","2021-02-03","2021-06-17","2021-06-17","2023-01-10"],"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":[["","70069000510","CYANOCOBALAM","INJ 1000MCG","13","Select","Select",""],["","55111017915","TIZANIDINE","TAB 2MG","90","Select","Select",""],["","00024592410","ADMELOG","INJ 100U\/ML","50","Select","Select",""],["","52817018110","CLONIDINE","TAB 0.2MG","60","Select","Select",""],["","43547040011","CYCLOBENZAPR","TAB 10MG","90","Select","Select",""],["","00074707090","SYNTHROID","175 MCG","30","Select","Select",""],["","00002773701","INSULIN LISP","INJ 100\/ML","90","Select","Select",""],["","57599080000","FREESTY LIBR","KIT 2 SENSOR","2","Select","Select",""],["","53885001110","ONETOUCH DEL","MIS PLUS 30G","600","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","43547036111","LOSARTAN POT","TAB 50MG","60","Select","Select",""],["","00002879959","HUMALOG KWIK","INJ 100\/ML","15","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","43598043611","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","00555912366","JOLESSA","TAB ","91","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","120","Select","Select",""],["","00143314250","DOXYCYCL HYC","CAP 100MG","14","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","12","Select","Select",""],["","57237007630","ONDANSETRON","TAB 8MG","60","Select","Select",""],["","00143992701","CIPROFLOXACN","TAB 250MG","14","Select","Select",""],["","08290320550","BD PEN NEEDL","MIS 32GX5\/32","100","Select","Select",""],["","65862035705","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","08508200005","OMNIPOD","MIS 5 PACK","15","Select","Select",""],["","00115180401","HYDROXYZ PAM","CAP 50MG","30","Select","Select",""],["","50742061510","METOPROL SUC","TAB 25MG ER","30","Select","Select",""],["","00832054111","BUMETANIDE","TAB 1MG","30","Select","Select",""],["","00378668977","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","00904679480","ASPIRIN LOW","CHW 81MG","30","Select","Select",""],["","00363058714","ASPIRIN 81","TAB 81MG EC","90","Select","Select",""],["","55111012405","ATORVASTATIN","TAB 80MG","90","Select","Select",""],["","56151014260","TRUPLUS LANC","MIS 28G","100","Select","Select",""],["","42571025201","CLINDAMYCIN","CAP 300MG","28","Select","Select",""],["","76385012350","METHOCARBAM","TAB 500MG","60","Select","Select",""],["","56151149002","TRUE METRIX","KIT AIR","1","Select","Select",""],["","08222710031","PEN NEEDLES","MIS 32GX4MM","100","Select","Select",""],["","00378181977","LEVOTHYROXIN","TAB 200MCG","90","Select","Select",""],["","53885004401","ONE TOUCH","KIT VERIO FL","1","Select","Select",""],["","11917019871","TENS THERAPY","MIS PAIN RLF","1","Select","Select",""],["","00832105410","BACLOFEN","TAB 10MG","30","Select","Select",""],["","00002751001","HUMALOG","100\/ML","10","Select","Select",""],["","59267100003","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","58160084252","BOOSTRIX","INJ ","0","Select","Select",""],["","00378728153","LEVONOR\/ETHI","TAB ESTRADIO","91","Select","Select",""],["","08508200005","OMNIPOD DASH","MIS PODS","45","Select","Select",""],["","57599000101","FREESTYLE","KIT SENSOR","6","Select","Select",""],["","68462010630","ONDANSETRON HCL","8 MG","30","Select","Select",""],["","65862039010","ONDANSETRON ODT","4 MG","90","Select","Select",""],["","00002773701","INSULIN LISPRO","100\/ML","90","Select","Select",""],["","76385012350","METHOCARBAMOL","500 MG","60","Select","Select",""],["","42806016105","HYDROXYZINE HCL","50 MG","90","Select","Select",""],["","08508200005","OMNIPOD DASH PODS (GEN","4)","15","Select","Select",""],["","57599080000","FREESTYLE LIBRE","2 SENSOR","6","Select","Select",""],["","00406051205","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","60","Select","Select",""],["","00093216568","NALOXONE HCL","4 MG","2","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":""}]}]}