{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"THURMAN  L HARGROVE","gend":0,"add":"14310 BOYDTON PLANK ROAD","city":"WARFIELD","state":"VA","zip":"23889-9998","dob":"1960-02-22","age":"","mstatus":"","insh":"2386604*01","cliId":"","pno":8046475337,"cno":8046475337,"email":"","ename":"","eno":"","pphy":"POWERS, DAVID C MD","ppno":4345842025,"pcpadd":"514 W ATLANTIC ST","pcpcity":"SOUTH HILL","pcpstate":"VA","pcpzip":"23970-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4344472240,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.3213","Z96.1","N17.0","NO DATA","I48.91","I31.4","I48.0","I48.3","I10.","E11.9","N18.9","D64.9","R06.83","B37.0","E11.22","N28.9","Z79.4","R07.9","R60.9","M10.9","E08.21","F10.20","Z68.31","H25.12","Z68.32","H59.033","Z01.810","Z68.29","H25.11","K62.5","Z00.00","E11.65","K21.9","Z68.30","Z28.21","E11.3299","E11.51","E11.42","E11.29","E11.21","N17.9","F10.10","I25.10","R94.31","I73.9","Z01.818","D68.9","D12.0","K57.30","K29.90","E86.0","E87.5","R00.2","E78.5","H43.813","K31.89","D12.5","D53.9","I25.119","I50.22","D68.69","K92.1","I13.0","I50.30","R18.8","I48.92","Z79.84"],"date":["2022-06-10","2023-02-24","2022-11-23","2023-03-31","2023-04-20","2022-11-23","2023-03-31","2023-03-27","2023-03-31","2023-03-27","2023-03-27","2022-12-09","2023-04-20","2023-04-20","2023-04-20","2023-04-20","2023-04-20","2023-01-09","2022-08-26","2022-08-26","2022-08-26","2022-08-26","2023-03-31","2021-12-09","2022-06-14","2022-03-18","2022-08-26","2022-08-26","2021-12-28","2022-09-01","2022-10-07","2022-10-07","2023-03-31","2022-10-07","2022-10-07","2022-10-07","2023-03-31","2022-10-07","2022-10-07","2023-03-31","2023-01-09","2021-08-03","2022-11-18","2021-11-01","2021-11-01","2022-08-19","2022-11-21","2022-09-01","2022-09-01","2022-09-15","2022-11-18","2022-11-18","2022-11-18","2023-04-20","2023-02-24","2022-09-01","2022-09-15","2022-06-14","2023-03-31","2023-03-31","2022-06-06","2022-06-14","2022-11-21","2022-11-18","2022-11-18","2022-11-18","2022-11-18"],"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":[["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","60758011905","PREDNISOLONE","SUS 1% OP","5","Select","Select",""],["","16729022501","SPIRONOLACT","TAB 25MG","15","Select","Select",""],["","68645058259","METFORMIN","TAB 500MG","60","Select","Select",""],["","68645019159","METOPROL TAR","TAB 100MG","60","Select","Select",""],["","50228018010","GABAPENTIN","300 MG","270","Select","Select",""],["","68645051554","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","64980051405","TIMOLOL MAL","SOL 0.5% OP","5","Select","Select",""],["","72205000390","ROSUVASTATIN","TAB 10MG","30","Select","Select",""],["","68645059354","LISINOPRIL","TAB 40MG","90","Select","Select",""],["","61314012605","KETOROLAC","SOL 0.005","10","Select","Select",""],["","00310626060","XIGDUO XR","5MG-1000MG","60","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","69315031228","PROCTO-MED","CRE HC 2.5%","28","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","00024576105","SOLIQUA","100-33 100-33\/ML","15","Select","Select",""],["","00002143380","TRULICITY","INJ 0.75\/0.5","2","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","12","Select","Select",""],["","65862073205","AMIODARONE","TAB 200MG","30","Select","Select",""],["","00832054111","BUMETANIDE","TAB 1MG","30","Select","Select",""],["","49502039475","INSULIN GLAR","INJ 100U\/ML","12","Select","Select",""],["","49502039475","INSULIN GLARGINE-YFGN","100\/ML (3)","15","Select","Select",""],["","68645051554","AMLODIPINE BESYLATE","5 MG","90","Select","Select",""],["","65862073205","AMIODARONE HCL","200 MG","30","Select","Select",""],["","00597015330","JARDIANCE","25 MG","90","Select","Select",""],["","68645059459","FAMOTIDINE","20 MG","180","Select","Select",""],["","60432053716","NYSTATIN","100000\/ML","160","Select","Select",""],["","57599080000","FREESTYLE LIBRE","2 SENSOR","2","Select","Select",""],["","31722071390","PANTOPRAZOLE SODIUM","40 MG","30","Select","Select",""],["","68645019159","METOPROLOL TARTRATE","100 MG","60","Select","Select",""],["","31722070190","LOSARTAN POTASSIUM","50 MG","30","Select","Select",""],["","31722071101","SILDENAFIL CITRATE","100 MG","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":""}]}]}