{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MONIQUE THOMPSON","gend":1,"add":"3308 CLIFF AVE","city":"RICHMOND","state":"VA","zip":"23222-9998","dob":"1989-11-25","age":"","mstatus":"","insh":"1319081*01","cliId":"","pno":8043491046,"cno":8043491046,"email":"","ename":"","eno":"","pphy":"GALGANO, KIMBERLY M MD","ppno":8042884084,"pcpadd":"7515 RIGHT FLANK RD","pcpcity":"MECHANICSVILLE","pcpstate":"VA","pcpzip":"23116-9998","pcpcounty":"","pcpid":"","pcpname":"Virginia Women's Center","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8045592046,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S16.1XXA","S46.911A","V49.40XA","F31.81","F41.9","G47.00","R41.840","F31.32","F31.62","F90.1","F33.1","J45.909","Z20.822","R05.9","H92.03","L03.032","M79.89","F41.1","S93.401A","J40.","L08.9","I10.","Z01.419","Z32.02","F43.23","J45.901","M25.571","S60.011A","S90.01XA","Z79.51","T71.9XXA","M25.511","Z32.01","R11.2","S63.91XA","S69.91XA","J45.31","E87.6","L72.0","L73.9","O98.53","U07.1","S63.501A","S39.012A","J20.9","F32.4","Z30.42","R52.","R09.89","R07.89","M79.644","R06.7","O99.719","L30.9","O99.519","Z3A.00","R21.","O98.52","O99.02","D64.9","O60.14X0","O16.4","Z37.0","O62.3","O71.4","O62.2","O99.52","Z3A.35","Z79.899","R51.9","S80.862A","M79.605","L02.811","L02.416","L03.116","S63.630A","S60.021A","F90.9","F43.22","O16.2","O14.92","O99.512","NO DATA","O26.852","R10.9","O26.892","O99.352","G40.909","Z3A.22","L20.89","L98.8","R10.84","V89.2XXA","Z3A.36","Z39.0","J45.41"],"date":["2021-02-05","2021-02-05","2021-02-05","2021-04-29","2023-04-17","2021-04-29","2021-04-29","2021-11-30","2022-08-01","2022-08-01","2023-04-05","2023-03-18","2023-02-25","2022-11-01","2022-10-09","2022-10-15","2022-10-15","2023-04-06","2022-12-23","2021-04-08","2023-03-01","2022-02-02","2022-03-30","2022-09-28","2022-10-20","2022-12-02","2022-05-17","2022-11-01","2022-11-01","2022-11-01","2021-02-01","2021-02-01","2021-06-29","2021-06-29","2022-12-02","2022-12-02","2022-12-23","2023-01-17","2023-01-17","2021-11-15","2022-01-16","2022-01-16","2022-02-24","2022-07-05","2023-02-25","2022-09-19","2023-03-31","2022-10-09","2022-10-09","2023-03-18","2023-03-18","2023-03-18","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2022-07-26","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-01-14","2022-02-02","2022-07-27","2022-07-27","2022-08-29","2022-08-29","2022-10-30","2023-03-18","2023-03-25","2021-03-08","2023-02-28","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2023-03-01","2023-03-01","2021-10-14","2021-10-14","2022-01-14","2022-01-15","2023-02-25"],"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":[["","00904759080","FEROSUL","TAB 325MG","90","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","14","Select","Select",""],["","00406851001","OXYCODONE","TAB 10MG","6","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","10","Select","Select",""],["","68462019005","NAPROXEN","500 MG","30","Select","Select",""],["","50742062001","NIFEDIPINE","TAB 30MG ER","30","Select","Select",""],["","70954006020","PREDNISONE","20 MG","15","Select","Select",""],["","72578008601","DESONIDE","0.05 %","30","Select","Select",""],["","66993037179","MEDROXYPR AC","INJ 150MG\/ML","1","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","00093506105","HYDROXYZ HCL","TAB 25MG","90","Select","Select",""],["","65862052790","VENLAFAXINE","CAP 37.5 ER","30","Select","Select",""],["","67877024901","QUETIAPINE","TAB 50MG","30","Select","Select",""],["","65162062711","TRAMADOL HCL","TAB 50MG","18","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","30","Select","Select",""],["","76204060060","IPRATROPIUM\/","SOL ALBUTER","180","Select","Select",""],["","00781107905","ALPRAZOLAM","1 MG","60","Select","Select",""],["","00555097402","AMPHET\/DEXTR","TAB 30MG","60","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","20","Select","Select",""],["","00713022615","TRIAMCINOLON","CRE 0.00025","15","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","7","Select","Select",""],["","00713028031","BACITRACIN","OIN 500\/GM","28","Select","Select",""],["","42806031250","DOXYCYCL HYC","TAB 100MG","14","Select","Select",""],["","51672207502","BACITR ZINC","OIN 500\/GM","57","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","65862018501","CLINDAMYCIN","CAP 150MG","45","Select","Select",""],["","59651036205","IBUPROFEN","800 MG","20","Select","Select",""],["","00093314705","CEPHALEXIN","500 MG","20","Select","Select",""],["","68382091634","METHYLPRED","TAB 4MG","21","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","20","Select","Select",""],["","00031873912","ROBITUSSIN","LIQ 20-400","118","Select","Select",""],["","14539067306","DIFLUNISAL","TAB 500MG","20","Select","Select",""],["","76204060030","IPRATROPIUM-ALBUTEROL","0.5-3MG\/3","90","Select","Select",""],["","67877025001","QUETIAPINE FUMARATE","100 MG","30","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","83490031065","VIOS AEROSOL DELIVERY SYSTEM","","1","Select","Select",""],["","83490022137","PARI LC PLUS NEBULIZER","","1","Select","Select",""],["","00713022880","TRIAMCINOLONE ACETONIDE","0.1 %","80","Select","Select",""],["","42806071501","BENZONATATE","200 MG","20","Select","Select",""],["","11917004918","ACETAMINOPHEN","500 MG","20","Select","Select",""],["","10702000350","PROMETHAZINE HCL","25 MG","20","Select","Select",""],["","66993037179","MEDROXYPROGESTERONE ACETATE","150 MG\/ML","1","Select","Select",""],["","42806031250","DOXYCYCLINE HYCLATE","100 MG","14","Select","Select",""],["","00378113401","KETOROLAC TROMETHAMINE","10 MG","15","Select","Select",""],["","57237007710","ONDANSETRON ODT","4 MG","12","Select","Select",""],["","68462086635","CLINDAMYCIN PHOSPHATE","1 %","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":""}]}]}