{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LATANYA DANIELS","gend":1,"add":"108 SOUTH ST UNIT A","city":"HENRICO","state":"VA","zip":"23075-9998","dob":"1976-10-15","age":"","mstatus":"","insh":"2128041*01","cliId":"","pno":8043499532,"cno":8043499532,"email":"","ename":"","eno":"","pphy":"GIUSTI, MASSIMO MD","ppno":8043231804,"pcpadd":"STE H 681 HIOAKS ROAD,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23225-9998","pcpcounty":"","pcpid":"","pcpname":"Cardiovascular Associates Of Virginia","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8042720306,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K21.9","E11.9","Z79.84","L73.2","I42.1","R06.02","R94.31","I10.","E66.01","Z98.84","D64.9","E46.","R53.83","E55.9","E53.9","Z13.1","Z90.3","K43.2","I42.9","Z86.16","Z88.8","Z91.041","Z88.5","E11.59","I15.2","Z68.41","I08.1","Z68.42","E78.5","Z86.010","I42.8","E13.9","Z20.822","K43.9","NO DATA","I11.9","M19.90","Z79.899","Z79.52","Z95.818"],"date":["2023-03-20","2023-03-20","2023-03-20","2022-11-01","2023-02-06","2023-02-15","2023-02-06","2023-02-06","2023-03-20","2023-03-20","2022-05-04","2022-05-04","2022-05-04","2022-05-04","2022-05-04","2022-05-04","2022-06-01","2022-06-01","2022-11-01","2022-11-01","2022-11-01","2022-11-01","2022-11-01","2023-02-02","2023-02-02","2023-03-20","2022-06-14","2022-06-14","2022-08-02","2022-11-01","2022-05-19","2022-05-19","2022-06-01","2022-10-31","2023-03-20","2023-03-20","2023-03-20","2023-03-20","2023-03-20","2023-05-05"],"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","180","Select","Select",""],["","70010049110","METFORMIN","TAB 500MG ER","120","Select","Select",""],["","43547042409","LOSARTAN\/HCT","TAB 100-25","90","Select","Select",""],["","00169280015","SAXENDA","INJ 18MG\/3ML","15","Select","Select",""],["","00378668877","PANTOPRAZOLE","TAB 20MG","30","Select","Select",""],["","58160082152","ENGERIX-B","INJ 20MCG\/ML","1","Select","Select",""],["","68180065208","DOXYCYC MONO","CAP 100MG","60","Select","Select",""],["","76385011350","CARVEDILOL","TAB 25MG","60","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","8","Select","Select",""],["","08290320109","BD PEN NEEDL","MIS 31GX8MM","100","Select","Select",""],["","70377000315","SIMVASTATIN","TAB 20MG","90","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","31722070530","VALACYCLOVIR","TAB 1GM","21","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","15","Select","Select",""],["","70010049110","METFORMIN HCL ER","500 MG","360","Select","Select",""],["","08290320109","BD PEN NEEDL MIS","31GX8MM","100","Select","Select",""],["","65862085901","FAMOTIDINE TAB","20MG","60","Select","Select",""],["","00378668877","PANTOPRAZOLE TAB","20MG","30","Select","Select",""],["","43547042409","LOSARTAN\/HCT TAB","100-25","30","Select","Select",""],["","70010049110","METFORMIN TAB","500MG ER","120","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","8","Select","Select",""],["","76385011350","CARVEDILOL TAB","25MG","60","Select","Select",""],["","58160082152","ENGERIX-B INJ","20MCG\/ML","1","Select","Select",""],["","68180065208","DOXYCYC MONO CAP","100MG","60","Select","Select",""],["","70377000315","SIMVASTATIN TAB","20MG","30","Select","Select",""],["","00169280015","SAXENDA INJ","18MG\/3ML","15","Select","Select",""],["","00093101042","MUPIROCIN OIN","2%","22","Select","Select",""],["","31722070530","VALACYCLOVIR TAB","1GM","21","Select","Select",""],["","00603188016","LIDOCAINE PAD","5%","15","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":""}]}]}