{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SYED  H RIZVI","gend":0,"add":"2915 SARA JEAN TERRACE","city":"GLEN ALLEN","state":"VA","zip":"23060-9998","dob":"1963-01-15","age":"","mstatus":"","insh":"2169287*01","cliId":"","pno":8044054442,"cno":8044054442,"email":"","ename":"","eno":"","pphy":"DESHMUKH, PRAVIN M MD","ppno":8046122980,"pcpadd":"STE 204 12320 W BROAD ST","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23233-9998","pcpcounty":"","pcpid":"","pcpname":"Bon Secours Short Pump Primary Care","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8043602437,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.89","R06.83","Z68.36","R51.9","G47.8","H54.8","H40.1131","H52.202","I87.2","I83.813","I83.893","I83.891","H40.9","H34.11","H40.1133","H25.13","H02.89","I87.023","R42.","I10.","E78.00","J30.1","C85.90","E29.1","N52.9","M79.605","M79.7","R73.03","M25.50","H10.13","Z79.899","M79.2","M79.89","Z87.442","L40.9","M25.541","M25.542","Z68.37","I83.812","I83.892","NO DATA","G90.09","L40.0","I89.0","R60.9","I83.811","E55.9","M17.0","R53.83","E53.8","R76.11","Z11.1","R53.1","E11.9","E78.5","H81.10","Z68.35","I20.9","R06.02","R07.9","H34.231","S43.402A","S52.502A","M79.642","I20.0","R06.00","E66.01","D69.2","R63.5","H54.7","H10.33","H52.203","G45.9","R19.09","F32.89","H54.61","R00.2","E78.2","L40.50"],"date":["2022-04-05","2022-04-05","2021-03-01","2021-02-19","2021-02-19","2021-02-19","2021-05-21","2021-05-21","2022-12-12","2021-08-13","2021-08-13","2021-06-18","2021-07-28","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-10-01","2022-01-06","2023-01-16","2023-01-16","2022-04-05","2023-01-16","2022-06-10","2023-01-16","2022-06-10","2022-12-12","2022-12-12","2022-06-10","2022-06-10","2023-03-31","2022-12-12","2022-12-12","2022-12-12","2023-03-31","2022-12-12","2022-12-12","2023-01-16","2021-07-30","2021-07-30","2021-08-26","2021-08-26","2023-03-31","2021-10-18","2021-06-16","2021-06-11","2022-04-05","2021-09-07","2022-04-05","2021-09-07","2021-09-13","2021-09-13","2021-12-26","2021-12-27","2021-12-27","2021-12-27","2021-12-27","2021-02-25","2021-03-26","2021-12-26","2021-08-05","2022-07-13","2022-07-13","2022-07-13","2021-02-24","2021-02-24","2021-02-24","2021-03-08","2021-06-09","2021-03-08","2021-06-23","2021-06-23","2021-12-26","2021-01-28","2021-01-28","2021-01-28","2021-03-01","2021-03-01","2023-03-31"],"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":[["","65702040710","ACCU-CHEK","TES AVIVA PL","100","Select","Select",""],["","23155000810","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","99073070827","FREESTYLE","TES LITE","100","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA","100","Select","Select",""],["","56151146001","TRUE METRIX","TES GLUCOSE","100","Select","Select",""],["","55513013760","OTEZLA","TAB 30MG","60","Select","Select",""],["","69842031278","8HR PAIN ER","TAB 650MG","30","Select","Select",""],["","50428028552","ACETAMINOPHN","TAB 500MG","60","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","4","Select","Select",""],["","59779046708","ASPIRIN LOW","CHW 81MG","90","Select","Select",""],["","38779058505","COAL TAR","MIS ","100","Select","Select",""],["","45802005505","TRIAMCINOLON","OIN 0.001","454","Select","Select",""],["","43598043611","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","43386009662","CLOBETASOL","OIN 0.0005","60","Select","Select",""],["","00378702393","ACITRETIN","25 MG","60","Select","Select",""],["","68180098103","LISINOPRIL","20 MG","180","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","70377002711","ATORVASTATIN","TAB 10MG","90","Select","Select",""],["","68462041820","LIDOCAINE","OIN 0.05","106","Select","Select",""],["","53746051101","SPIRONOLACT","TAB 25MG","90","Select","Select",""],["","50383023310","DORZOL\/TIMOL","SOL 22.3-6.8","10","Select","Select",""],["","64980051415","TIMOLOL MAL","SOL 0.5% OP","15","Select","Select",""],["","67877056110","METFORMIN","TAB 500MG","180","Select","Select",""],["","24208046325","LATANOPROST","SOL 0.00005","10","Select","Select",""],["","42023010401","APLISOL","INJ 5\/0.1ML","1","Select","Select",""],["","59779054462","ARTHRTS PAIN","TAB 650MG","30","Select","Select",""],["","50428708884","BP MONITOR","KIT AUTO","1","Select","Select",""],["","16571066101","MECLIZINE","TAB 25MG","12","Select","Select",""],["","00280200020","BAYER ASA","TAB 325MG","30","Select","Select",""],["","00536105405","ASPIRIN","TAB 325MG","30","Select","Select",""],["","45802065078","LORATADINE","10 MG","90","Select","Select",""],["","68084077725","ACETAMINOPHE","TAB 650MG ER","30","Select","Select",""],["","00093301856","TADALAFIL","TAB 10MG","15","Select","Select",""],["","00023599060","ANDRODERM","2 MG\/24 HR","60","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","30","Select","Select",""],["","62332014131","CELECOXIB","CAP 100MG","30","Select","Select",""],["","49884041872","TESTOSTERONE","GEL 1%(25MG)","75","Select","Select",""],["","70069000701","OLOPATADINE","DRO 0.001","5","Select","Select",""],["","43547040211","FUROSEMIDE","40 MG","90","Select","Select",""],["","00245531911","KLOR-CON M20","TAB 20MEQ ER","30","Select","Select",""],["","70710122501","AMITRIPTYLIN","TAB 10MG","60","Select","Select",""],["","50742061510","METOPROL SUC","TAB 25MG ER","30","Select","Select",""],["","21922001707","CLOBETASOL PROPIONATE","0.05 %","60","Select","Select",""],["","45802005505","TRIAMCINOLONE ACETONIDE","0.1 %","454","Select","Select",""],["","67877056110","METFORMIN HCL","500 MG","180","Select","Select",""],["","50742061510","METOPROLOL SUCCINATE","25 MG","90","Select","Select",""],["","70069000701","OLOPATADINE HCL","0.1 %","5","Select","Select",""],["","00116200116","CHLORHEXIDINE GLUCONATE","0.12 %","473","Select","Select",""],["","70710122501","AMITRIPTYLINE HCL","10 MG","90","Select","Select",""],["","43598043611","NITROGLYCERIN","0.4 MG","25","Select","Select",""],["","00245531911","KLOR-CON M","20 20 MEQ","90","Select","Select",""],["","68180072103","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","57894064011","TREMFYA","100 MG\/ML","1","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE","50 MCG","16","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":""}]}]}