{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SEAN M JONES","gend":0,"add":"3105 NORTH ST APT B","city":"RICHMOND","state":"VA","zip":"23223-9998","dob":"1987-07-20","age":"","mstatus":"","insh":"20052018*01","cliId":"","pno":8047292697,"cno":8047292697,"email":"","ename":"","eno":"","pphy":"BHAT, SHRIDHAR MD","ppno":8048194000,"pcpadd":"107 S 5TH STREET,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23219-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048195221,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R56.9","S01.512A","X58.XXXA","F10.239","T14.8XXA","X95.9XXA","E87.2","E83.42","R73.9","F39.","F10.232","S27.321A","K92.0","D62.","E87.6","F17.210","Y90.8","Z20.822","Z86.59","F17.200","NO DATA","G40.89","F31.4","R10.9","D69.6","R74.8","K85.20","B17.9","R79.89","I47.2","D64.9","E87.1","D69.59","K70.10","F12.90","Z28.21","S00.83XA","S60.511A","X50.3XXA","K21.9","R10.13","R07.9","Z87.19","K85.90","Z87.81","Z91.81","R00.0","R94.01","K75.9","R16.0","R19.7","R51.9","Z86.69","R53.81","F10.129","G40.909","M79.672","R41.0","F10.10","F43.21","D53.9","M25.511","F12.10","F60.9","Z91.5","R07.89","Z79.899","Z83.3","R41.82","R27.0","S01.01XA","Y93.01","R53.1","W18.30XA","U07.1","M79.605","M62.838","F10.230","F12.99","Z66.","G47.00","R47.1","D50.9","S60.812A","R10.84","Z72.0","F25.9","G40.509","Z53.9","I51.7","B19.9","R11.0","R94.31","R26.89","F10.20","M70.42","R52.","F10.231","K74.60","R55.","E63.9","Z59.00","V62.84","W19.XXXS","S09.90XS","E51.2","F10.229","Z91.14","Z04.9","R94.5","R20.8","M79.609","R74.01","E83.39","S21.132A","W34.00XA","J34.89","S00.03XA","R22.0","M79.89","R93.7","S00.12XA","R25.1","T14.90XA","G89.11","F19.230","S00.81XA","F14.90","D63.8","Z68.1","F60.2","S22.42XA","K29.20","R29.6","Y90.2","S00.212A","S00.211A","Y90.6","Z71.41","M25.562","Z71.1","R26.81","R11.10","R11.2","S09.90XA","W01.0XXA","S01.81XA","S01.111A","F12.20","F21.","E86.1","K76.0","D72.829","R50.9","Z56.0"],"date":["2023-08-16","2023-07-07","2021-01-02","2022-07-21","2021-01-01","2021-01-01","2022-04-08","2023-08-16","2021-01-01","2021-01-01","2021-01-01","2021-01-01","2021-01-01","2021-01-02","2022-07-16","2023-08-16","2021-08-18","2023-08-16","2023-07-11","2023-07-07","2023-08-19","2021-05-31","2021-11-10","2021-03-27","2023-07-07","2023-08-16","2022-06-07","2021-05-04","2022-07-16","2021-03-31","2023-08-16","2023-07-07","2021-07-19","2023-08-16","2022-05-10","2021-05-02","2021-05-02","2021-05-02","2021-05-02","2021-05-02","2021-05-31","2022-04-08","2021-06-30","2022-06-07","2021-06-01","2021-05-31","2021-10-13","2021-06-29","2021-07-22","2021-07-22","2021-07-22","2023-04-30","2021-10-13","2022-04-19","2022-10-15","2022-07-16","2022-02-19","2022-05-26","2021-08-22","2021-02-15","2021-02-15","2021-02-15","2021-02-15","2023-08-16","2021-07-19","2021-06-30","2021-07-19","2022-05-10","2022-01-15","2021-08-23","2023-07-07","2021-08-19","2022-01-13","2023-07-07","2021-10-18","2022-01-11","2022-01-11","2023-07-10","2022-06-07","2022-06-07","2023-07-07","2021-08-20","2022-04-08","2022-10-15","2021-05-02","2021-05-31","2021-07-19","2021-05-01","2021-05-04","2021-03-28","2021-05-28","2021-05-28","2022-04-19","2021-08-22","2022-07-21","2021-12-06","2022-01-11","2023-08-16","2022-05-10","2022-05-10","2022-05-10","2022-05-10","2023-07-11","2021-08-16","2021-08-16","2022-04-08","2021-08-18","2022-01-15","2022-04-09","2022-07-20","2021-08-23","2022-01-14","2022-04-08","2022-07-21","2021-01-02","2021-01-02","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2022-04-08","2022-05-09","2022-06-06","2022-06-06","2022-06-07","2022-07-16","2022-07-16","2022-07-16","2022-07-16","2021-05-29","2021-05-29","2021-05-29","2021-05-29","2021-10-27","2021-10-27","2021-06-28","2021-06-28","2022-01-11","2021-12-17","2023-04-30","2023-04-30","2023-05-01","2023-07-07","2023-07-07","2023-07-13","2023-07-07","2023-07-11","2023-07-07","2023-07-07","2023-07-07","2023-08-16","2023-08-16","2023-08-16"],"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":[["","65862085901","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","70010013701","NAPROXEN","TAB 250MG","20","Select","Select",""],["","00005475756","CENTRUM","TAB MEN","30","Select","Select",""],["","68382039801","POT CHLORIDE","TAB 20MEQ ER","5","Select","Select",""],["","58602075521","PAIN RELIEF","TAB 500MG","30","Select","Select",""],["","00832712411","DIVALPROEX","TAB 500MG DR","60","Select","Select",""],["","50383077504","LIDOCAINE","SOL 2% VISC","15","Select","Select",""],["","00555015902","CHLORDIAZEPOXIDE HCL","25 MG","23","Select","Select",""],["","00005475756","CENTRUM TAB MEN","","30","Select","Select",""],["","65862085901","FAMOTIDINE TAB","20MG","30","Select","Select",""],["","70010013701","NAPROXEN TAB","250MG","20","Select","Select",""],["","68382039801","POT CHLORIDE TAB","20MEQ ER","5","Select","Select",""],["","58602075521","PAIN RELIEF TAB","500MG","30","Select","Select",""],["","50383077504","LIDOCAINE SOL","2% VISC","100","Select","Select",""],["","00832712411","DIVALPROEX TAB","500MG DR","60","Select","Select",""],["","60258017101","MAGNESIUM OXIDE","400 MG","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":""}]}]}