{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROBERT TURNER","gend":0,"add":"5421 BRADLEY PINE CIR APT F","city":"SANDSTON","state":"VA","zip":"23150-9998","dob":"1964-05-22","age":"","mstatus":"","insh":"2426578*01","cliId":"","pno":5026777029,"cno":5026777029,"email":"","ename":"","eno":"","pphy":"CAMPBELL, CARA NP","ppno":8047832505,"pcpadd":"517 W GRACE STREET,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23220-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8046491635,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","I25.10","E66.9","Z23.","E78.5","NO DATA","E66.01","Z68.36","Z00.00","G47.30","R06.83"],"date":["2022-09-26","2022-06-20","2022-09-19","2022-06-20","2022-09-26","2022-09-26","2022-09-26","2022-09-26","2022-05-16","2022-09-19","2022-09-19"],"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":[["","70436000203","POT CHLORIDE","TAB 10MEQ ER","60","Select","Select",""],["","69842031278","8HR PAIN ER","TAB 650MG","180","Select","Select",""],["","62332004890","LOSARTAN\/HCT","TAB 50-12.5","30","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","61958250101","BIKTARVY","TAB ","30","Select","Select",""],["","50428693430","SPECTRAVITE","TAB ADVANCED","30","Select","Select",""],["","64380071207","BENZONATATE","CAP 100MG","30","Select","Select",""],["","76385012450","METHOCARBAM","TAB 750MG","180","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","23155000810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","49702024613","DOVATO","TAB 50-300MG","30","Select","Select",""],["","43547030603","ARIPIPRAZOLE","TAB 20MG","30","Select","Select",""],["","70436001002","BUPROPN HCL","TAB 150MG XL","30","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","49702023113","TRIUMEQ","TAB ","90","Select","Select",""],["","80681016900","VITAMIN D3","TAB 25MCG","30","Select","Select",""],["","27241006903","SILDENAFIL","TAB 100MG","30","Select","Select",""],["","31604002683","D3","TAB 1000UNIT","30","Select","Select",""],["","49483069901","ACETAMIN","TAB 650MG","180","Select","Select",""],["","69842054447","ARTHRTS PAIN","TAB 650MG","180","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","43547042309","LOSARTAN\/HCT TAB","50-12.5","90","Select","Select",""],["","61958250101","BIKTARVY TAB","","30","Select","Select",""],["","49702024613","DOVATO TAB","50-300MG","30","Select","Select",""],["","43547030603","ARIPIPRAZOLE TAB","20MG","30","Select","Select",""],["","76385012450","METHOCARBAM TAB","750MG","180","Select","Select",""],["","49702023113","TRIUMEQ TAB","","30","Select","Select",""],["","70436001002","BUPROPN HCL TAB","150MG XL","30","Select","Select",""],["","68180072003","AMLODIPINE TAB","5MG","90","Select","Select",""],["","80681016900","VITAMIN D","3 TAB 25MCG","30","Select","Select",""],["","50111056001","TRAZODONE TAB","50MG","30","Select","Select",""],["","31604002683","D","3 TAB 1000UNIT","30","Select","Select",""],["","70377002911","ATORVASTATIN TAB","40MG","90","Select","Select",""],["","27241006903","SILDENAFIL TAB","100MG","30","Select","Select",""],["","69097094312","GABAPENTIN CAP","300MG","30","Select","Select",""],["","69842054447","ARTHRTS PAIN TAB","650MG","150","Select","Select",""],["","49483069901","ACETAMIN TAB","650MG","180","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":""}]}]}