{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ALYAKLLAH R","gend":1,"add":"ALEGDE8251ELCRIC NW","city":"RICHMOND","state":"VA","zip":"23231-3854","dob":"1982-07-26","age":"","mstatus":"","insh":"52017922","cliId":"","pno":"3940819001","cno":"","email":"","ename":"","eno":"","pphy":"HABIB, AYSHA","ppno":8046122980,"pcpadd":"12320 W BROAD ST STE 204,","pcpcity":"Henrico","pcpstate":"VA","pcpzip":"23233-7603","pcpcounty":"","pcpid":"","pcpname":"BON SECOURS SHORT PUMP PRIMARY CARE.","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"1528EDGELAWN CIRCLE","add3":"","madd1":"1528EDGELAWN CIRCLE","madd2":"APT A","madd3":"","mcity":"RICHMOND","mstate":"VA","mzip":"23231-3854","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","R68.89","O99.512","J20.9","J04.0","F17.200","Z20.828","Z3A.27","R05","O99.342","F41.9","F31.9","O99.332","Z86.19","Z85.41","F41.1","O26.893","Z3A.34","O99.343","O98.413","B19.20","F17.210","Z88.5","Z79.899","Z03.71","O99.013","Z13.83","Z36.85","O69.81X0","O99.892","Z79.891","Z37.0","Z3A.37","O76","O99.324","O99.344","Z20.822","O99.334","Z90.79","O80","Z3A.00","O99.323","T40.3X1A","T65.91XA","F11.23","T50.901A","T50.904A","N94.89","Z30.431","F13.20","N89.8","F11.21","J18.9","R06.02","R09.81","R91.8","F43.10","N92.6","N92.1","Z97.5","H72.03","N76.0","E88.09","R05.9","R53.1","Z01.419","Z68.26","H92.12","H72.02","F15.21","M54.2","S00.03XA","G93.40","S09.90XA","R09.02","R40.4","E87.6","S06.0X9A","W19.XXXA","J96.01","I44.1","T76.11XA","R40.2122","D64.9","T14.8XXA","B18.2","Z91.81","F31.60","T14.90XA","W08.XXXA","G93.41","F19.10","F43.12","F11.11"],"date":["2023-06-01","2021-01-30","2021-01-02","2022-04-13","2021-01-02","2022-04-13","2021-01-02","2021-01-02","2021-09-08","2021-01-02","2022-06-02","2021-02-25","2021-01-02","2021-02-25","2021-09-08","2022-04-12","2021-01-30","2021-01-30","2021-01-30","2021-01-30","2021-01-30","2021-09-08","2021-01-30","2021-02-25","2021-01-30","2021-02-09","2021-02-09","2021-02-09","2021-02-25","2021-02-25","2021-02-25","2021-02-25","2021-02-25","2021-02-25","2021-02-25","2021-02-25","2022-09-01","2021-02-25","2021-02-25","2021-02-25","2021-02-25","2021-02-25","2021-04-29","2021-04-29","2021-04-29","2021-04-29","2021-04-29","2021-05-27","2021-07-19","2021-09-27","2022-02-07","2021-10-12","2022-09-01","2022-08-31","2021-09-08","2022-08-31","2021-11-03","2021-10-14","2021-10-14","2021-12-13","2021-11-05","2021-12-13","2022-04-13","2022-04-13","2022-04-13","2022-06-02","2022-06-02","2022-06-16","2022-06-16","2023-01-30","2022-08-31","2022-08-31","2022-09-04","2022-08-31","2022-08-31","2022-09-01","2022-09-05","2022-09-01","2022-09-01","2022-09-05","2022-09-02","2022-09-01","2022-09-01","2022-09-04","2022-09-01","2022-09-01","2022-09-01","2022-09-01","2022-09-04","2022-09-01","2022-09-05","2022-09-05","2023-05-18","2023-06-01"],"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":[["","00591024105","LORAZEPAM","TAB 1MG","14","Select","Select",""],["","45963055750","GABAPENTIN","CAP 400MG","240","Select","Select",""],["","65862014636","SUMATRIPTAN","TAB 25MG","9","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","00378623301","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","120","Select","Select",""],["","00781107905","ALPRAZOLAM","TAB 1MG","120","Select","Select",""],["","51672125906","CLOBETASOL","OIN 0.0005","45","Select","Select",""],["","61874014530","VRAYLAR","CAP 4.5MG","30","Select","Select",""],["","00555901858","TRI-SPRINTEC","TAB","28","Select","Select",""],["","00555089902","ESTRADIOL","TAB 0.5MG","21","Select","Select",""],["","50419042301","MIRENA","IUD SYSTEM","1","Select","Select",""],["","00168034646","TERCONAZOLE","CRE 0.004","45","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","11877001140","BINAXNOW COV","KIT HOME TES","2","Select","Select",""],["","69315030805","CIPROFLOXACN","SOL 0.3% OP","5","Select","Select",""],["","00093317431","ALBUTEROL SUL","FAT E","8.5","Select","Select",""],["","64380071307","BENZONATATE","CAP 200MG","15","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","9","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":""}]}]}