{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIM L BLAND","gend":1,"add":"12502 MIKES LN APT D","city":"CHURCH ROAD","state":"VA","zip":"23833-9998","dob":"1972-10-18","age":"","mstatus":"","insh":"7995318*01","cliId":"","pno":8042655865,"cno":8042655865,"email":"","ename":"","eno":"","pphy":"BOODRAM, KADARNATH S MD","ppno":8045267900,"pcpadd":"430 CLAIRMONT COURT SUITE 123,","pcpcity":"COLONIAL HEIGHTS","pcpstate":"VA","pcpzip":"23834-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8045267195,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R20.2","R00.0","E83.51","E87.6","I10.","F17.210","Z72.89","F10.129","R20.0","F19.10","F10.10","R74.8","F10.19","K92.1","Z68.1","R63.6","F17.200","K92.2","E86.0","F10.239","J20.9","J06.9","Z03.818","D50.0","K29.00","Z20.822","NO DATA","R94.31","K31.89","D64.9","R07.9","E43.","R64.","K76.6","E87.1","K72.90","I86.4","R62.7","Z79.899","Z82.49","M79.606","R74.01","R03.0","R17."],"date":["2022-10-26","2022-05-21","2022-02-21","2022-04-03","2023-03-30","2022-04-01","2022-02-21","2022-04-29","2022-10-26","2022-10-26","2023-03-30","2022-04-01","2022-04-01","2022-04-01","2022-12-26","2022-04-01","2023-03-30","2022-04-04","2022-04-03","2022-05-21","2022-11-22","2023-03-09","2023-03-09","2022-04-04","2022-04-04","2022-05-21","2023-02-22","2022-05-21","2022-04-04","2022-04-04","2023-02-22","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2023-03-30","2023-03-30","2021-12-14","2022-04-01"],"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":[["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","50268085115","VITAMIN B1","TAB 100MG","30","Select","Select",""],["","57664047758","METOPROL TAR","TAB 50MG","180","Select","Select",""],["","11534016503","FOLIC ACID","1 MG","30","Select","Select",""],["","68382039801","POT CHLORIDE","TAB 20MEQ ER","30","Select","Select",""],["","00378668977","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","74312058911","B-12","SUB 2500MCG","30","Select","Select",""],["","00054074287","ALBUTEROL","AER HFA","20","Select","Select",""],["","45963067611","METOPROL SUC","TAB 50MG ER","30","Select","Select",""],["","65862020199","LOSARTAN POT","TAB 25MG","30","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","4","Select","Select",""],["","00406117003","NALTREXONE","TAB 50MG","30","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","31722051901","HYDRALAZINE HCL","10 MG","60","Select","Select",""],["","65862020299","LOSARTAN POTASSIUM","50 MG","30","Select","Select",""],["","55111046701","METOPROLOL SUCCINATE","50 MG","90","Select","Select",""],["","29300039810","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","45963055550","GABAPENTIN","100 MG","60","Select","Select",""],["","47781060730","DISULFIRAM","250 MG","30","Select","Select",""],["","00781185220","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","20","Select","Select",""],["","00173085910","BREO ELLIPTA","100-25MCG","60","Select","Select",""],["","00378668977","PANTOPRAZOLE SODIUM","40 MG","90","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","00054074287","ALBUTEROL SULFATE HFA","90 MCG","13.4","Select","Select",""],["","00406117003","NALTREXONE HCL","50 MG","30","Select","Select",""],["","66993013597","FLUTICASONE-VILANTEROL","100-25MCG","60","Select","Select",""],["","68180072103","AMLODIPINE TAB","10MG","30","Select","Select",""],["","50268085115","VITAMIN B","1 TAB 100MG","30","Select","Select",""],["","57664047758","METOPROL TAR TAB","50MG","180","Select","Select",""],["","11534016503","FOLIC ACID TAB","1MG","30","Select","Select",""],["","68382039801","POT CHLORIDE TAB","20MEQ ER","30","Select","Select",""],["","00378668977","PANTOPRAZOLE TAB","40MG","60","Select","Select",""],["","00054074287","ALBUTEROL AER HFA","","7","Select","Select",""],["","45963067611","METOPROL SUC TAB","50MG ER","90","Select","Select",""],["","74312058911","B-","12 SUB 2500MCG","30","Select","Select",""],["","00406117003","NALTREXONE TAB","50MG","30","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","4","Select","Select",""],["","00781808926","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","65862020199","LOSARTAN POT TAB","25MG","30","Select","Select",""],["","42806040021","METHYLPRED TAB","4MG","21","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":""}]}]}