{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROBBIE BONNER","gend":0,"add":"3305 NORTH AVE","city":"RICHMOND","state":"VA","zip":"23222-9998","dob":"1964-01-22","age":"","mstatus":"","insh":"2402981*01","cliId":"","pno":8046773890,"cno":8046773890,"email":"","ename":"","eno":"","pphy":"LEMAY, MEGAN S MD","ppno":8048289357,"pcpadd":"417 N 11TH STREET,","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":8048287591,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M24.812","M25.512","M50.30","M50.10","S59.901A","S09.90XA","J10.1","B20.","R50.9","R05.9","R06.02","NO DATA","Z20.822","R55.","R42.","F33.1","F41.1","Z21.","Z23.","Z11.59","Z89.511","F10.20","N52.9","R63.4","Z00.00","Z13.9","R51.9","R03.0","F11.129","T50.901A","M54.2","S50.311A","V87.7XXA","Y92.410","Z04.1","I20.8","E55.9","E78.5","Z79.899","U07.1","J06.9","Z59.0","F41.9","M62.838","R53.1","I51.7","F33.2","S16.1XXA","M54.12","E78.2","F17.210","M47.812","I10."],"date":["2022-01-10","2022-01-19","2023-04-17","2022-05-13","2022-05-27","2022-05-27","2022-12-02","2022-12-02","2022-12-02","2022-12-02","2022-12-02","2022-12-02","2022-12-02","2021-11-10","2021-11-10","2022-02-06","2022-02-06","2022-01-26","2022-01-26","2022-03-01","2023-04-17","2022-05-13","2023-02-01","2022-06-29","2023-04-17","2023-04-17","2022-08-27","2021-08-10","2021-08-10","2021-08-10","2022-02-04","2022-05-27","2022-05-27","2022-05-27","2022-05-27","2022-06-01","2022-08-24","2022-08-24","2022-08-24","2021-08-13","2021-08-13","2021-08-13","2021-11-12","2022-01-06","2022-05-26","2022-05-26","2021-08-23","2022-01-28","2022-01-19","2022-08-24","2021-11-10","2022-01-19","2023-04-26"],"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":[["","61958250101","BIKTARVY","50-200-25","30","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","64380073706","VITAMIN D","2 1250 MCG","1","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","21","Select","Select",""],["","00904672059","ACETAMIN","TAB 500MG","30","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","65162010250","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","00603254421","BUT\/APAP\/CAF","TAB ","30","Select","Select",""],["","70010077005","METHOCARBAM","TAB 750MG","40","Select","Select",""],["","00536123441","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","69238126601","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","00004080085","TAMIFLU","CAP 75MG","10","Select","Select",""],["","65862020199","LOSARTAN POTASSIUM","25 MG","90","Select","Select",""],["","52817033010","CYCLOBENZAPR TAB","5MG","21","Select","Select",""],["","16571020150","DICLOFENAC TAB","75MG DR","60","Select","Select",""],["","00904672059","ACETAMIN TAB","500MG","30","Select","Select",""],["","65162010250","GABAPENTIN CAP","300MG","90","Select","Select",""],["","64380080707","IBUPROFEN TAB","800MG","90","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","1","Select","Select",""],["","61958250101","BIKTARVY TAB","","30","Select","Select",""],["","00603254421","BUT\/APAP\/CAF TAB","","30","Select","Select",""],["","70010077005","METHOCARBAM TAB","750MG","40","Select","Select",""],["","00536123441","ASPIRIN LOW TAB","81MG EC","30","Select","Select",""],["","69238126601","OSELTAMIVIR CAP","75MG","10","Select","Select",""],["","00004080085","TAMIFLU CAP","75MG","10","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":""}]}]}