{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LYSIA ODOM","gend":1,"add":"5405 WELLINGTON RIDGE RD APT C","city":"HENRICO","state":"VA","zip":"23231-9998","dob":"1985-04-25","age":"","mstatus":"","insh":"2032938*01","cliId":"","pno":"540\/624-0012","cno":"","email":"","ename":"","eno":"","pphy":"HABIB, AYSHA MD","ppno":"804\/612-2980","pcpadd":"STE 204 12320 W BROAD ST","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23233,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS SHORT PUMP PRIMARY CARE","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/360-2437","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["V58.89","F41.0","L03.211","R11.0","S01.409A","S81.802A","L28.0","G43.119","Z76.0","Z68.22","F43.21","Z68.20","K21.9","F41.8","G43.109","F48.1","F12.20","F13.10","F17.210","F41.9","G47.00","N76.0","Z13.89","D48.5","T23.262A","T31.0","X10.2XXA","F29.","F17.200","F44.9","F60.89","Z00.00","Z11.59","R50.9","T23.202A","L70.0","G43.019","F51.01","F32.9","S01.511A","W20.8XXA","Z01.419","Z30.432","Z11.51","F19.10","T74.91XA","R51.","F30.8","I49.9","L72.8","F05.","L02.91","S09.93XA","L08.9","B96.89","R52.","T23.242A","N94.89"],"date":["2020-12-11","2020-11-23","2020-11-23","2021-12-01","2020-12-05","2020-12-05","2021-03-11","2019-08-21","2019-07-11","2021-12-01","2019-08-21","2020-02-27","2020-02-27","2020-02-27","2020-02-27","2021-01-22","2021-01-22","2021-01-22","2021-01-19","2021-01-21","2021-01-21","2021-01-22","2021-01-19","2021-07-19","2020-11-16","2020-11-23","2020-11-17","2021-01-22","2021-01-22","2021-01-20","2021-01-22","2021-03-25","2021-03-25","2020-08-13","2020-11-19","2021-05-11","2021-12-01","2020-06-03","2020-06-03","2020-09-06","2020-09-06","2021-02-25","2021-02-25","2021-02-25","2021-02-25","2021-02-25","2020-08-12","2021-01-17","2021-04-22","2021-09-13","2021-01-18","2020-08-12","2020-09-09","2020-09-09","2020-09-09","2020-09-09","2020-11-17","2021-08-27"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","","SUMATRIPTAN"," SUMATRIPTAN ","6","Select","Select",""],["","","TOPIRAMATE"," TOPIRAMATE ","60","Select","Select",""],["","","AMITRIPTYLIN"," AMITRIPTYLIN ","90","Select","Select",""],["","","PROMETHAZINE"," PROMETHAZINE ","15","Select","Select",""],["","","EMGALITY"," EMGALITY ","1","Select","Select",""],["","","NICOTINE"," NICOTINE ","28","Select","Select",""],["","","ALPRAZOLAM"," ALPRAZOLAM ","10","Select","Select",""],["","","METOCLOPRAM"," METOCLOPRAM ","12","Select","Select",""],["","","OMEPRAZOLE","CAP 20MG","","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","","PAROXETINE","TAB 10MG","","Select","Select",""],["","","TRAMADOL","TAB 50MG","","Select","Select",""],["","","CLINDAMY\/BEN","GEL 1-5%","","Select","Select",""],["","","CLINDAMYCIN","SOL 0.01","","Select","Select",""],["","","BUSPIRONE","TAB 10MG","","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","Select","Select",""],["","","MUPIROCIN","OIN 0.02","","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","","OXYCODONE","TAB 5MG","","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","","CHLORHEX","SOL 0.0012","","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":""}]}]}