{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ASHLEY ISBELL","gend":1,"add":"1403 CLAIBORNE ST","city":"RICHMOND","state":"VA","zip":"23220-9998","dob":"1988-06-19","age":"","mstatus":"","insh":"1628773*01","cliId":"","pno":8045103349,"cno":8045103349,"email":"","ename":"","eno":"","pphy":"RIEDT, STACY NP","ppno":8048830046,"pcpadd":"15078 BROWN PLEASANTS ROAD,","pcpcity":"MONTPELIER","pcpstate":"VA","pcpzip":"23192-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048830048,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","F33.1","N76.0","R73.09","R63.5","Z79.899","Z71.3","Z68.36","E55.9","Z68.32","N93.9","F31.4","N87.1","Z32.02","F41.9","F14.10","F15.10","F12.10","F90.2","F31.9","F33.2","F41.1","F33.0","F10.20","R51.9","J02.9","Z20.822","F90.0","F32.9","N39.0","N87.0","K52.9","R11.2","F91.9","R19.7","Z01.42","E66.9","Z68.33","H00.021","G56.01","Z01.419","I49.8","R94.31","R07.89","R06.02","F17.290"],"date":["2022-04-26","2021-10-18","2022-07-15","2022-07-29","2022-07-29","2023-07-26","2023-07-26","2022-09-07","2023-07-26","2023-07-26","2021-02-04","2021-10-11","2023-05-15","2023-05-15","2023-01-24","2021-02-19","2021-02-19","2021-02-19","2021-04-27","2021-06-20","2022-04-26","2022-04-26","2021-01-02","2022-01-24","2022-09-23","2022-09-23","2023-08-06","2023-01-24","2023-01-24","2022-10-24","2023-03-27","2022-08-24","2022-08-24","2021-07-11","2022-08-24","2023-03-06","2023-03-06","2023-03-06","2022-06-28","2022-06-28","2022-12-08","2023-08-06","2023-08-06","2023-08-06","2023-08-06","2023-08-06"],"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":[["","16729020001","BUSPIRONE TAB","5MG","90","Select","Select",""],["","70436001102","BUPROPN HCL TAB","300MG XL","90","Select","Select",""],["","16571066450","METRONIDAZOL TAB","500MG","14","Select","Select",""],["","00169413212","OZEMPIC INJ","2\/1.5ML","2","Select","Select",""],["","00169185189","NOVOFINE MIS","32GX6MM","100","Select","Select",""],["","68462019005","NAPROXEN TAB","500MG","20","Select","Select",""],["","61314062810","POLYMYXIN B\/ SOL TRIMETHP","","10","Select","Select",""],["","00093227434","AMOX\/K CLAV TAB","500-125","20","Select","Select",""],["","00169280015","SAXENDA INJ","18MG\/3ML","15","Select","Select",""],["","00169451714","WEGOVY INJ","1.7MG","2","Select","Select",""],["","08290320749","BD PEN NEEDL MIS","32GX6MM","100","Select","Select",""],["","54092038701","ADDERALL XR CAP","20MG","30","Select","Select",""],["","59417010210","VYVANSE CAP","20MG","30","Select","Select",""],["","00228306011","AMPHET\/DEXTR CAP","20MG ER","30","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","4","Select","Select",""],["","47781030301","NITROFURANTN CAP","100MG","14","Select","Select",""],["","65862039010","ONDANSETRON TAB","4MG ODT","15","Select","Select",""],["","00169452414","WEGOVY","2.4MG\/0.75","3","Select","Select",""],["","65862039010","ONDANSETRON ODT","4 MG","15","Select","Select",""],["","00172392570","DIAZEPAM","2 MG","30","Select","Select",""],["","00228306011","DEXTROAMPHETAMINE-AMPHET ER","20 MG","30","Select","Select",""],["","00406051201","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","3","Select","Select",""],["","69452015120","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","54092038701","ADDERALL XR","20 MG","30","Select","Select",""],["","49483060350","IBUPROFEN","600 MG","15","Select","Select",""],["","00115180401","HYDROXYZINE PAMOATE","50 MG","12","Select","Select",""],["","68180012202","CEPHALEXIN","500 MG","14","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA","90 MCG","8.5","Select","Select",""],["","70436001102","BUPROPN HCL","TAB 300MG XL","90","Select","Select",""],["","16729020001","BUSPIRONE","TAB 5MG","90","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","61314062810","POLYMYXIN B\/","SOL TRIMETHP","10","Select","Select",""],["","00093227434","AMOX\/K CLAV","TAB 500-125","20","Select","Select",""],["","00169280015","SAXENDA","INJ 18MG\/3ML","6","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","00169185189","NOVOFINE","MIS 32GX6MM","100","Select","Select",""],["","16571066450","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","00228306011","AMPHET\/DEXTR","CAP 20MG ER","30","Select","Select",""],["","59417010210","VYVANSE","CAP 20MG","30","Select","Select",""],["","08290320749","BD PEN NEEDL","MIS 32GX6MM","100","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","15","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","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":""}]}]}