{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHONQUWELL BYNUM","gend":0,"add":"109 PERRY STREET LOFTS","city":"PETERSBURG","state":"VA","zip":"23803-9998","dob":"1992-07-03","age":"","mstatus":"","insh":"20024830*01","cliId":"","pno":4346376937,"cno":4346376937,"email":"","ename":"","eno":"","pphy":"SMITH, WALLY R MD","ppno":8048286938,"pcpadd":"417 N 11TH STREET,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23298-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048283741,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M87.059","G89.29","F11.10","D57.20","F11.90","D57.00","I21.4","J96.11","F17.200","F12.90","NO DATA","Z53.29","D72.829","Z90.81","Z88.5","Z99.81","Z90.49","Z88.8","R52.","D57.219","Z20.822","J34.89","F17.210","D57.1","M87.051","F17.290","R45.4","Z79.891","Z86.16","R07.9","M79.601","T50.901A","R11.2","F11.20","M25.551","M25.552","Z87.891","F32.9","M87.9","R94.31","M87.052","R60.0","Z79.899","A41.9","N39.0","M79.604","R50.81","Z83.2","B96.20","F10.239","E55.9","H20.9","H36.","H53.9","H53.142","H40.052","H52.7","H10.32","H10.9","H57.12"],"date":["2023-05-05","2022-03-04","2022-02-19","2023-08-07","2023-08-07","2023-02-15","2022-02-19","2022-02-19","2022-02-19","2022-02-19","2023-05-16","2022-02-19","2022-02-20","2022-02-19","2022-02-19","2022-02-20","2022-02-19","2022-02-19","2022-07-26","2022-07-26","2023-02-05","2023-02-05","2023-05-13","2023-06-05","2022-03-04","2021-09-17","2021-09-17","2021-09-17","2021-10-18","2022-05-14","2022-05-14","2022-07-26","2022-07-26","2022-01-15","2023-02-15","2023-02-15","2023-02-15","2022-01-14","2022-03-21","2022-05-14","2021-10-18","2021-10-18","2021-10-18","2021-02-26","2021-02-26","2022-02-20","2022-02-20","2021-02-25","2021-02-25","2022-01-12","2023-05-05","2023-06-15","2023-05-16","2023-05-16","2023-05-16","2023-06-15","2023-06-15","2023-05-13","2023-05-13","2023-05-13"],"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":[["","00555088202","HYDROXYUREA","500 MG","60","Select","Select",""],["","00406853001","OXYCODONE","TAB 30MG","120","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59011044010","OXYCONTIN","TAB 40MG CR","180","Select","Select",""],["","65862032804","ALENDRONATE","TAB 35MG","12","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","90","Select","Select",""],["","53746020401","OXYCOD\/APAP","TAB 10-325MG","143","Select","Select",""],["","49281042150","FLUZONE QUAD","INJ 2021-22","0","Select","Select",""],["","80777027399","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","00115180401","HYDROXYZ PAM","CAP 50MG","21","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","15","Select","Select",""],["","00536340401","NICOTINE POL","GUM 2MG CINN","100","Select","Select",""],["","00093216568","NALOXONE HCL","SPR ","2","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","10702000801","OXYCODONE HCL","15 MG","90","Select","Select",""],["","65862032804","ALENDRONATE SODIUM","35 MG","4","Select","Select",""],["","70069000701","OLOPATADINE HCL","0.1 %","5","Select","Select",""],["","60758011905","PREDNISOLONE ACETATE","1 %","5","Select","Select",""],["","64980051405","TIMOLOL MALEATE","0.5 %","5","Select","Select",""],["","24208091055","ERYTHROMYCIN","5 MG\/GRAM","3.5","Select","Select",""],["","50111056001","TRAZODONE TAB","50MG","15","Select","Select",""],["","00536340401","NICOTINE POL GUM","2MG CINN","100","Select","Select",""],["","00115180401","HYDROXYZ PAM CAP","50MG","21","Select","Select",""],["","00406851501","OXYCODONE TAB","15MG","90","Select","Select",""],["","59011044010","OXYCONTIN TAB","40MG CR","180","Select","Select",""],["","45802081184","NALOXONE HCL SPR","4MG","2","Select","Select",""],["","68462015713","ONDANSETRON TAB","4MG ODT","20","Select","Select",""],["","53746020401","OXYCOD\/APAP TAB","10-325MG","150","Select","Select",""],["","49884072401","HYDROXYUREA CAP","500MG","60","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":""}]}]}