{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VILEETA MCLENA-FLEMING","gend":1,"add":"205 NEWBRIDGE CIR APT A","city":"RICHMOND","state":"VA","zip":"23223-9998","dob":"1988-08-13","age":"","mstatus":"","insh":"1244428*01","cliId":"","pno":7578139038,"cno":7578139038,"email":"","ename":"","eno":"","pphy":"JACKSON, RICHARD A MD","ppno":8042257148,"pcpadd":"304 E LEIGH ST","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23219-9998","pcpcounty":"","pcpid":"","pcpname":"Dominion Medical Associates, INC.","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8042257159,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z3A.01","R11.2","V23.87","O26.891","J30.89","C50.912","C50.412","Z17.0","Z68.22","Z68.20","R92.8","G62.0","T45.1X5A","Z68.21","Z51.11","C50.812","U07.1","Z20.828","R51.9","R05.9","NO DATA","Z92.21","Z09.","Z87.59","Z30.09","O20.0","Z32.01","Z11.3","Z90.13"],"date":["2022-04-26","2022-10-10","2022-04-26","2022-04-26","2022-07-28","2022-08-30","2023-04-14","2023-04-14","2022-10-27","2023-04-14","2022-08-18","2023-02-02","2023-02-02","2023-02-02","2023-01-19","2023-03-29","2021-02-08","2021-12-31","2021-12-31","2021-12-31","2022-08-18","2023-02-08","2022-04-28","2022-04-28","2022-04-28","2022-04-22","2022-04-22","2022-06-20","2023-03-29"],"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":[["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","54","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","30","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","33342007007","OLANZAPINE","TAB 10MG","30","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","15","Select","Select",""],["","50383066730","LIDO\/PRILOCN","CRE 2.5-2.5%","30","Select","Select",""],["","47781091401","DEXAMETHASON","TAB 4MG","60","Select","Select",""],["","45963055550","GABAPENTIN","100 MG","30","Select","Select",""],["","67618010160","COLACE","100 MG","60","Select","Select",""],["","00406055201","OXYCODONE HCL","5 MG","20","Select","Select",""],["","64380080807","IBUPROFEN","600 MG","40","Select","Select",""],["","59651030030","TAMOXIFEN CITRATE","20 MG","30","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":""}]}]}