{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AMY M JONES","gend":1,"add":"5404 NUTMEG CT","city":"RICHMOND","state":"VA","zip":"23225-9998","dob":"1979-09-21","age":"","mstatus":"","insh":"5270669*01","cliId":"","pno":8049441509,"cno":8049441509,"email":"","ename":"","eno":"","pphy":"BISHOP, KATHERINE COREY MD","ppno":8042884084,"pcpadd":"12129 GRAHAM MEADOWS DR,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23233-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8042822601,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","Z20.822","I10.","E87.6","Z79.3","F17.210","Z88.6","R11.2","G44.209","R07.89","K21.9","J42.","R51.9","R03.0","NO DATA","F43.10","R07.1","R07.9","F31.81","F33.3","F41.9","R09.81","J02.9","R06.02","Z71.6","R53.83","J06.9","R50.9","R05.9","U07.1","N92.0","N93.9","N94.5","N92.1","F17.200","J20.9","R07.81","R42.","M54.9","R11.0","T23.211A","T23.131A","Z23.","T23.101A","Z30.09","Z30.40","N92.6","N76.0","Z32.02","Z30.42","N64.4","Z01.419","B34.9","R19.7","R94.39"],"date":["2022-10-23","2023-06-05","2023-06-14","2022-08-20","2022-01-02","2023-05-15","2022-01-02","2023-02-19","2022-08-13","2023-05-15","2023-06-05","2022-08-13","2023-06-14","2022-08-16","2022-08-16","2022-08-16","2022-09-13","2023-06-05","2021-11-12","2021-11-12","2022-09-23","2021-12-28","2021-12-28","2023-05-22","2022-09-23","2023-01-21","2023-02-19","2023-06-14","2023-06-05","2022-08-20","2022-09-22","2022-09-22","2022-09-22","2022-09-22","2023-06-14","2022-12-09","2022-12-09","2023-03-07","2023-03-07","2023-03-07","2021-02-08","2021-02-08","2021-02-08","2021-02-08","2022-10-25","2022-10-25","2021-03-25","2021-03-25","2021-03-25","2023-05-10","2022-10-25","2023-05-10","2023-06-14","2023-06-14","2023-05-26"],"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":[["","00406012405","HYDROCO\/APAP","TAB 7.5-325","14","Select","Select",""],["","65162046550","IBUPROFEN","600 MG","30","Select","Select",""],["","00548570100","MEDROXYPR AC","INJ 150MG\/ML","1","Select","Select",""],["","29300022701","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","65862001705","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","62756018388","OXCARBAZEPIN","TAB 150MG","60","Select","Select",""],["","68180044601","QUETIAPINE","TAB 50MG","30","Select","Select",""],["","43547028111","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","31722095801","BENZONATATE","CAP 200MG","12","Select","Select",""],["","45802014762","CETIRIZ\/PSE","TAB 5-120MG","20","Select","Select",""],["","11822505400","RA CETIRI-D","TAB 5-120MG","20","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","62332025118","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00054418625","DEXAMETHASON","TAB 6MG","10","Select","Select",""],["","69367020301","BUT\/APAP\/CAF","TAB ","10","Select","Select",""],["","51660094024","ALLERGY RELF","TAB 5-120MG","20","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","20","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","20","Select","Select",""],["","50580072812","ZYRTEC-D","TAB 5-120MG","20","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","59310058020","PROAIR RESPI","AER ","1","Select","Select",""],["","68462039610","OMEPRAZOLE","20 MG","30","Select","Select",""],["","00904673080","ACETAMIN","TAB 500MG","20","Select","Select",""],["","11822574200","RA ANTACID","SUS ANTIGAS","355","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","11822880300","VITAMIN C","TAB 500MG","10","Select","Select",""],["","57896086501","ZINC SULFATE","TAB 220MG","45","Select","Select",""],["","29033000301","SUCRALFATE","TAB 1GM","30","Select","Select",""],["","00093506201","HYDROXYZ HCL","TAB 50MG","20","Select","Select",""],["","10939074844","MUCUS RLF D","TAB 60-600MG","12","Select","Select",""],["","13668010401","ISOSORB MONO","TAB 30MG ER","15","Select","Select",""],["","29300039705","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","68462063945","NITROGLYCERN","SUB 0.4MG","100","Select","Select",""],["","11822059042","MUCUS RELIEF","TAB 60-600MG","12","Select","Select",""],["","63824005718","MUCINEX D","TAB 60-600MG","12","Select","Select",""],["","00054001925","PREDNISONE","50 MG","5","Select","Select",""],["","00536133321","GG\/PSE ER","TAB 600-60MG","12","Select","Select",""],["","00548570100","MEDROXYPROGESTERONE ACETATE","150 MG\/ML","1","Select","Select",""],["","70010016201","LORATADINE","10 MG","20","Select","Select",""],["","69230031837","OMEPRAZOLE MAGNESIUM","20 MG","90","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","35046000322","MAGNESIUM GLUCONATE","27 MG(500)","6","Select","Select",""],["","00904673080","ACETAMINOPHEN","500 MG","30","Select","Select",""],["","00093031401","KETOROLAC TROMETHAMINE","10 MG","20","Select","Select",""],["","10702025301","BUT\/APAP\/CAF TAB","","20","Select","Select",""],["","62332025118","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","45802014762","CETIRIZ\/PSE TAB","5-120MG","20","Select","Select",""],["","66993001968","ALBUTEROL AER HFA","","18","Select","Select",""],["","11822505400","RA CETIRI-D TAB","5-120MG","20","Select","Select",""],["","50580072812","ZYRTEC-D TAB","5-120MG","20","Select","Select",""],["","00173068220","VENTOLIN HFA AER","","18","Select","Select",""],["","00054418625","DEXAMETHASON TAB","6MG","10","Select","Select",""],["","51660094024","ALLERGY RELF TAB","5-120MG","20","Select","Select",""],["","31722095801","BENZONATATE CAP","200MG","12","Select","Select",""],["","31722071390","PANTOPRAZOLE TAB","40MG","20","Select","Select",""],["","00172572860","FAMOTIDINE TAB","20MG","20","Select","Select",""],["","59310057922","PROAIR HFA AER","","8","Select","Select",""],["","68462039610","OMEPRAZOLE CAP","20MG","20","Select","Select",""],["","59310058020","PROAIR RESPI AER","","1","Select","Select",""],["","00904673080","ACETAMIN TAB","500MG","20","Select","Select",""],["","29033000301","SUCRALFATE TAB","1GM","30","Select","Select",""],["","00904052360","VITAMIN C TAB","500MG","10","Select","Select",""],["","57896086501","ZINC SULFATE TAB","220MG","45","Select","Select",""],["","65162046550","IBUPROFEN TAB","600MG","20","Select","Select",""],["","68462063945","NITROGLYCERN SUB","0.4MG","100","Select","Select",""],["","65862018730","ONDANSETRON TAB","4MG","20","Select","Select",""],["","11822574200","RA ANTACID SUS ANTIGAS","","355","Select","Select",""],["","11822332470","RA ANTACID SUS ANTI-GAS","","355","Select","Select",""],["","29300039705","AMLODIPINE TAB","5MG","30","Select","Select",""],["","00093506201","HYDROXYZ HCL TAB","50MG","20","Select","Select",""],["","00548570100","MEDROXYPR AC INJ","150MG\/ML","1","Select","Select",""],["","13668010401","ISOSORB MONO TAB","30MG ER","15","Select","Select",""],["","63824005718","MUCINEX D TAB","60-600MG","12","Select","Select",""],["","11822059042","MUCUS RELIEF TAB","60-600MG","12","Select","Select",""],["","00603533715","PREDNISONE PAK","5MG","21","Select","Select",""],["","00536133321","GG\/PSE ER TAB","600-60MG","12","Select","Select",""],["","10939074844","MUCUS RLF D TAB","60-600MG","12","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":""}]}]}