{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DIANA BRADBURY","gend":1,"add":"1012 BUTLER BRANCH ROAD","city":"PETERSBURG","state":"VA","zip":"23805-9998","dob":"1959-05-14","age":"","mstatus":"","insh":"2438078*01","cliId":"","pno":8048963869,"cno":8048963869,"email":"","ename":"","eno":"","pphy":"LOBB, KEEFE H DO","ppno":8047175300,"pcpadd":"SUITE 117 11601 IRONBRIDGE ROAD","pcpcity":"CHESTER","pcpstate":"VA","pcpzip":"23831-9998","pcpcounty":"","pcpid":"","pcpname":"Ironbridge Family Practice","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8047487269,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["B49.","M00.051","M00.852","M00.251","R78.81","B95.62","Z45.2","Z51.81","Z79.2","NO DATA","G89.29","F98.8","Z79.01","Z99.3","Z98.1","Z85.3","Z91.81","Z47.89","A49.02","I82.432","Z89.621","R26.2","Z48.01","Z96.641","S71.001S","S71.101S","A41.9","D62.","B37.2","Z22.322","Z86.14","Z87.891","Z80.3","M19.90","B95.8","Z79.899","Z20.822","M00.9","M00.851","I82.4Y1","Z68.28","I82.512","I82.522","F41.9","Z92.3","Z01.818","I44.7","F99.","F90.0","F43.22","Z68.29","A41.02","B37.89","E66.9","Z80.6","Z86.718","M00.00","T81.89XA","S71.001A","Z00.00","B36.9","T81.49XA","B37.9","I82.422","M16.11","M25.551","M25.561","L03.115","M16.7","I82.401","G89.18","T82.528A","M79.661","R21.","M79.89","L03.90","M79.605","I82.532","D64.9"],"date":["2022-02-15","2022-11-25","2022-02-23","2022-07-18","2022-03-26","2022-10-12","2022-10-12","2022-04-04","2022-10-12","2022-05-23","2022-04-04","2022-04-04","2022-05-23","2022-04-04","2022-08-15","2022-08-15","2022-05-23","2023-03-02","2022-07-28","2022-07-28","2022-08-15","2022-07-28","2022-11-25","2022-11-25","2023-03-02","2023-03-02","2022-02-21","2022-02-21","2022-02-21","2022-02-21","2022-08-15","2022-08-15","2022-08-15","2022-08-22","2022-02-21","2022-02-21","2022-08-15","2022-08-22","2022-05-03","2022-05-03","2022-08-25","2022-05-23","2022-05-23","2022-05-23","2022-08-15","2022-07-15","2022-07-18","2022-07-18","2023-04-25","2023-04-25","2022-04-25","2022-02-28","2022-02-25","2022-08-15","2022-08-15","2022-08-15","2022-08-15","2022-09-01","2022-09-01","2022-02-02","2022-05-13","2022-08-25","2022-03-28","2022-05-03","2022-08-15","2022-07-20","2022-01-11","2022-08-16","2022-01-19","2022-04-28","2022-07-20","2022-02-24","2022-04-25","2022-04-25","2022-04-25","2022-04-28","2022-04-28","2022-04-28","2022-08-22"],"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":[["","57237000630","FLUCONAZOLE","TAB 200MG","14","Select","Select",""],["","00363016060","SENNA S","TAB 8.6-50MG","30","Select","Select",""],["","68462079965","NYSTAT\/TRIAM","OIN ","60","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","25","Select","Select",""],["","04142000024","FLORASTOR","CAP 250MG","120","Select","Select",""],["","00781324664","ENOXAPARIN","INJ 40\/0.4ML","9","Select","Select",""],["","64980014612","FLORANEX","GRA ","135","Select","Select",""],["","00363000220","EASY-LAX PLS","TAB 8.6-50MG","28","Select","Select",""],["","68308015230","NYSTATIN","100000\/G","30","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","63","Select","Select",""],["","65162062711","TRAMADOL HCL","TAB 50MG","15","Select","Select",""],["","50458057930","XARELTO","TAB 20MG","30","Select","Select",""],["","00168000215","TRIAMCINOLON","CRE 0.005","30","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","11917009215","FERROUS SULF","TAB 325MG","60","Select","Select",""],["","11917004918","ACETAMIN","TAB 500MG","100","Select","Select",""],["","00536354710","DAILY-VITE","TAB ","30","Select","Select",""],["","11917017101","MULTIVITAMIN","TAB IRON-FRE","30","Select","Select",""],["","00536124801","STIMULANT","TAB 8.6-50MG","28","Select","Select",""],["","00363053112","PAIN RELIEVE","TAB 500MG","100","Select","Select",""],["","11917020786","VITAMIN C","TAB 1000MG","30","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","60","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","60","Select","Select",""],["","57844011001","ADDERALL","10 MG","30","Select","Select",""],["","00713022515","TRIAMCINOLONE ACETONIDE","0.1 %","45","Select","Select",""],["","00555097402","DEXTROAMPHETAMINE-AMPHETAMINE","30 MG","30","Select","Select",""],["","00574200830","NYSTOP","100000\/G","60","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":""}]}]}