{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KATANA W HASBERRY","gend":1,"add":"3511 BARLEY PANEL CT","city":"RICHMOND","state":"VA","zip":"23223-9998","dob":"1990-04-20","age":"","mstatus":"","insh":"1684348*01","cliId":"","pno":8044976580,"cno":8044976580,"email":"","ename":"","eno":"","pphy":"RAJAB, MOHAMMAD MD","ppno":8042884827,"pcpadd":"7611 FOREST AVE SUITE 100,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23224-9998","pcpcounty":"","pcpid":"","pcpname":"Virginia Cardiovascular Specialists","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8042884494,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["U07.1","R53.1","I49.8","F41.9","Z09.","NO DATA","F33.2","F41.0","F60.3","R10.84","F33.1","O60.14X0","O98.52","O76.","Z37.0","B00.89","Z3A.36","O99.344","O99.354","Z34.83","R07.9","K59.00","A60.00","F32.9","A08.4","Z20.828","N30.00","R00.2","M25.561","M25.562","R11.0","E87.6","Z11.3","N89.8","Z32.02","F41.1","B34.9","O99.411","O21.0","R11.2","R42.","R20.0","N30.01","R00.0","R10.2","R10.9","O26.891","O99.891","R79.89","R82.71","Z87.891","Z3A.01","Z32.01","O21.9","Z3A.00","O64.0XX0","J04.0","J02.9","Z01.419","Z30.432","Z12.72","Z30.09","R50.9","J98.9","T50.905A","N73.9","R10.31","R10.32","Z23.","Z87.19","K59.04","O99.351","R07.89","Z80.3","Z3A.12","Z82.49","Z83.3","O21.1","Z76.89","R21.","J30.81","J30.89","J45.40","Z79.51","Z79.899","R19.7","Z20.822","J06.9","Z39.1","Z34.82","O47.03","O26.893","Z3A.35","Z87.42","R06.00","L29.9","L50.9","Z68.20","N76.0","O80.","R06.02","R53.83","I49.9","Z71.9","F41.8","O62.9","Z3A.24"],"date":["2021-09-08","2021-09-08","2022-12-15","2023-07-15","2022-02-03","2023-07-15","2022-02-25","2022-04-18","2022-02-25","2023-07-15","2023-06-21","2023-07-16","2023-07-15","2023-07-15","2023-07-16","2023-07-15","2023-07-16","2023-07-15","2023-07-15","2023-07-15","2022-07-03","2022-11-06","2022-09-21","2021-12-21","2021-06-27","2021-09-08","2022-10-30","2023-09-06","2021-10-20","2021-10-20","2022-12-13","2021-12-19","2021-11-10","2022-05-19","2022-05-19","2021-12-25","2022-07-03","2022-12-13","2023-06-06","2022-06-29","2022-01-30","2021-09-08","2021-10-22","2023-01-30","2023-05-08","2022-08-04","2022-12-13","2023-01-30","2022-12-13","2022-12-13","2023-09-06","2022-12-13","2022-12-14","2023-01-30","2023-07-15","2023-07-16","2023-09-06","2023-09-06","2021-05-18","2021-05-18","2021-05-18","2021-06-15","2021-09-08","2021-09-08","2021-12-30","2022-01-05","2022-01-05","2022-01-05","2022-01-05","2022-05-19","2022-09-26","2023-01-30","2023-01-30","2023-01-30","2023-01-30","2023-01-30","2023-01-30","2023-01-30","2021-03-17","2021-08-30","2022-09-21","2021-08-30","2021-08-30","2022-01-30","2023-05-08","2022-07-03","2022-12-07","2022-12-07","2023-06-26","2023-06-26","2023-07-05","2023-07-15","2023-07-05","2021-06-15","2021-08-04","2021-08-19","2021-08-19","2021-08-19","2022-01-16","2023-07-15","2021-02-05","2022-04-18","2023-09-07","2021-02-05","2022-09-21","2023-05-08","2023-05-08"],"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":[["","59651024701","MIDODRINE","TAB 5MG","90","Select","Select",""],["","00781320795","CEFTRIAXONE","INJ 500MG","1","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","68180065208","DOXYCYC MONO","CAP 100MG","28","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","28","Select","Select",""],["","68382003516","VENLAFAXINE","CAP 75MG ER","30","Select","Select",""],["","65162044210","MECLIZINE","TAB 25MG","15","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","31722070430","VALACYCLOVIR","500 MG","30","Select","Select",""],["","59651017401","DOXEPIN HCL","CAP 25MG","30","Select","Select",""],["","42806016105","HYDROXYZ HCL","TAB 50MG","60","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","00456120230","LINZESS","CAP 290MCG","30","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","14","Select","Select",""],["","67877021901","CEPHALEXIN","500 MG","14","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","65862039010","ONDANSETRON ODT","4 MG","10","Select","Select",""],["","68382003516","VENLAFAXINE HCL ER","75 MG","30","Select","Select",""],["","49483060450","IBUPROFEN","800 MG","30","Select","Select",""],["","59651021430","AZELASTINE HCL","137 MCG","30","Select","Select",""],["","16571040250","CETIRIZINE HCL","10 MG","30","Select","Select",""],["","49483034150","ACETAMINOPHEN","500 MG","60","Select","Select",""],["","00054350049","LIDOCAINE HCL VISCOUS","2 %","100","Select","Select",""],["","70954068910","PROCHLORPERAZINE MALEATE","10 MG","120","Select","Select",""],["","70700016301","PROGESTERONE","200 MG","90","Select","Select",""],["","00093220305","METOCLOPRAMIDE HCL","10 MG","120","Select","Select",""],["","00143928501","AMOXICILLIN","875 MG","20","Select","Select",""],["","68180016106","AZITHROMYCIN","500 MG","2","Select","Select",""],["","33342040535","LIDOCAINE","5 %","35.44","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":""}]}]}