{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHAKITA OLVIS","gend":1,"add":"13991 ROCKAHOCK ROAD","city":"LANEXA","state":"VA","zip":"23089-9998","dob":"1987-08-27","age":"","mstatus":"","insh":"20039530*01","cliId":"","pno":2702385379,"cno":2702385379,"email":"","ename":"","eno":"","pphy":"LIPATO, THOKOZENI MD","ppno":8048289357,"pcpadd":"1001 E LEIGH ST,","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":8048285791,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D57.00","M25.551","I10.","M54.5","G89.29","D72.829","F12.90","D57.20","F19.10","F17.210","D57.219","G89.4","F14.10","E66.9","Z76.5","Z68.35","Z79.899","Z90.49","Z86.711","Z88.5","Z88.0","Z88.8","Z91.041","Z83.3","Z83.2","M79.604","F17.200","Z88.6","R52.","R94.31","R79.89","D57.1","M87.00","K04.7","M79.89","J66.8","D57.80","M54.9","M79.662","R03.0","R10.84","J18.9","M79.605","M87.051","M87.052","F11.23","F14.90","Z86.73","R11.10","M25.561","M25.562","D57.3","Z86.718","Z82.49","M79.661","F19.90","M54.6","R30.0","M54.41","NO DATA","R11.2","J10.1","R74.01","E87.6","R07.89","F90.2","F11.10","F11.20","E87.5","E86.0","Z71.6","R07.9","Z20.822","M87.9","R05.","R51.9","K85.90","R10.13","M25.512","B34.9","R10.9","M87.059","M79.609","M62.81","Z88.3","I16.0","F41.9","Z90.81","F12.10","Z79.1","M25.552","L02.429","L02.416","R11.0","Z79.891","M25.511","Z68.38","R05.9","Z04.9","R09.02","R53.81","E66.09","K02.9","Z53.29","R50.9","I49.8","J11.1","R10.815","R06.89","M54.89","R00.1","H92.01","M79.602","G44.89","M79.606","R25.2","Z68.30","Z87.892","M87.812","M87.811","M87.850","F17.290"],"date":["2023-09-24","2023-05-23","2023-09-15","2021-08-23","2023-05-29","2022-12-04","2021-07-20","2023-09-15","2021-06-15","2023-09-14","2023-09-15","2023-09-14","2023-09-14","2023-09-14","2021-04-25","2021-11-24","2023-08-09","2022-12-01","2023-09-14","2023-09-14","2022-12-01","2022-11-27","2023-09-14","2023-09-14","2023-09-14","2021-12-09","2022-06-13","2021-10-13","2022-04-18","2022-04-19","2021-06-14","2023-08-09","2023-07-06","2021-10-16","2021-10-16","2021-10-25","2021-12-16","2023-08-09","2022-01-06","2022-05-25","2022-04-18","2022-04-19","2022-06-13","2021-07-30","2021-07-30","2021-01-11","2021-05-15","2021-02-17","2021-04-24","2021-11-04","2021-05-15","2021-05-19","2023-08-13","2023-09-14","2021-05-19","2021-06-15","2021-12-19","2022-04-19","2022-05-30","2023-07-06","2022-12-04","2022-12-04","2022-12-02","2022-12-04","2021-02-08","2021-02-15","2021-04-11","2023-09-14","2021-07-20","2021-07-20","2021-10-13","2023-09-24","2022-11-26","2021-08-23","2021-08-24","2022-11-27","2021-12-09","2021-12-28","2022-03-03","2022-01-28","2022-04-18","2021-03-26","2021-10-13","2021-10-13","2023-09-14","2022-03-17","2022-12-01","2023-09-14","2021-12-02","2021-12-02","2021-12-02","2021-08-30","2021-08-30","2022-11-27","2022-02-14","2021-12-27","2022-02-14","2022-02-14","2022-04-22","2021-06-09","2021-06-09","2021-10-13","2021-10-13","2021-10-13","2022-01-29","2022-04-19","2022-11-27","2021-01-12","2021-03-10","2021-06-09","2021-06-15","2021-08-23","2023-08-17","2021-04-24","2023-05-29","2023-05-29","2023-09-14","2023-09-14","2023-08-09","2023-08-09","2023-08-09","2023-08-17"],"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":[["","00406853001","OXYCODONE","TAB 30MG","180","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","42","Select","Select",""],["","43598058230","BUPREN\/NALOX","MIS 8-2MG","42","Select","Select",""],["","59011043020","OXYCONTIN","TAB 30MG CR","12","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","10","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","00093506101","HYDROXYZ HCL","TAB 25MG","14","Select","Select",""],["","00363037508","ANTI-DIARRHE","TAB 2MG","28","Select","Select",""],["","00406324401","HYDROMORPHON","TAB 4MG","25","Select","Select",""],["","52817019610","TRAMADOL HCL","TAB 100MG","28","Select","Select",""],["","62332000191","FAMOTIDINE","TAB 20MG","20","Select","Select",""],["","00536110888","NICOTINE TD","DIS 21MG\/24H","14","Select","Select",""],["","42858083940","BUPRENORPHIN","DIS 20MCG\/HR","4","Select","Select",""],["","00093031101","LOPERAMIDE","CAP 2MG","30","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","120","Select","Select",""],["","59011075204","BUTRANS","DIS 20MCG\/HR","4","Select","Select",""],["","31722052001","HYDRALAZINE","TAB 25MG","90","Select","Select",""],["","00781185220","AMOX\/K CLAV","TAB 875-125","14","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","49884072703","DOXYCYC MONO","CAP 100MG","14","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","20","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","14","Select","Select",""],["","00185032501","BENAZEP\/HCTZ","TAB 10-12.5","90","Select","Select",""],["","00093216568","NALOXONE HCL","4 MG","2","Select","Select",""],["","00406853001","OXYCODONE HCL","30 MG","180","Select","Select",""],["","00185032501","BENAZEPRIL-HYDROCHLOROTHIAZIDE","10-12.5MG","30","Select","Select",""],["","57237002801","AMOXICILLIN","500 MG","21","Select","Select",""],["","00406853001","OXYCODONE TAB","30MG","180","Select","Select",""],["","49884072703","DOXYCYC MONO CAP","100MG","14","Select","Select",""],["","70010077001","METHOCARBAM TAB","750MG","20","Select","Select",""],["","00781808926","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","65862017760","CEFDINIR CAP","300MG","14","Select","Select",""],["","68180072103","AMLODIPINE TAB","10MG","30","Select","Select",""],["","00185032501","BENAZEP\/HCTZ TAB","10-12.5","90","Select","Select",""],["","00093216568","NALOXONE HCL SPR","4MG","2","Select","Select",""],["","16714020030","ONDANSETRON TAB","4MG ODT","12","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":""}]}]}