{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RAVEN A RIVERS","gend":1,"add":"3603 TAPLOW CIR APT C","city":"MIDLOTHIAN","state":"VA","zip":"23112-9998","dob":"1994-02-24","age":"","mstatus":"","insh":"2192400*01","cliId":"","pno":8045104697,"cno":8045104697,"email":"","ename":"","eno":"","pphy":"DILLON, CAITLIN KIRIT MD","ppno":8044235050,"pcpadd":"13700 ST FRANCIS BLVD STE 510,","pcpcity":"MIDLOTHIAN","pcpstate":"VA","pcpzip":"23114-9998","pcpcounty":"","pcpid":"","pcpname":"Charter Colony Family Practice","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8044235048,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M62.89","M43.6","R29.3","M54.2","Z39.1","G43.809","J30.89","F51.02","O99.345","T88.7XXA","NO DATA","M54.89","M62.81","Z23.","Z3A.39","M54.12","Z01.419","Z68.34","G43.709","O35.0XX0","Z3A.25","Z34.82","Z34.83","O99.52","Z37.0","O98.52","J45.909","Q05.9","O76.","O75.89","B00.9","Z79.899","R20.0","R20.2","H00.015","Z30.430","Z32.02","Z3A.29","O66.2","O71.82","M41.117","Z87.728","N92.5","O20.0","Z34.80","O98.513","U07.1","O80."],"date":["2021-03-23","2021-03-23","2021-03-23","2023-04-20","2022-09-12","2022-02-28","2021-03-10","2022-08-31","2022-02-28","2021-11-22","2023-04-20","2022-05-11","2021-03-23","2022-10-21","2022-10-25","2021-01-19","2022-01-11","2022-01-11","2022-07-15","2022-08-15","2022-07-15","2022-09-12","2022-09-12","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2023-01-05","2023-02-08","2021-05-19","2023-01-16","2023-01-16","2022-08-15","2022-10-25","2022-10-25","2022-12-15","2022-12-15","2023-02-16","2022-03-31","2022-02-28","2022-08-31","2022-08-31","2022-10-25"],"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":[["","69097083305","SERTRALINE","TAB 25MG","30","Select","Select",""],["","68462030529","NORETHINDRON","TAB 0.35MG","84","Select","Select",""],["","10702025350","BUT\/APAP\/CAF","TAB ","20","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","51991081701","PROPRANOLOL","CAP 60MG ER","30","Select","Select",""],["","80777027315","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","90","Select","Select",""],["","33332032101","AFLURIA QUAD","INJ 2021-22","0","Select","Select",""],["","65862039110","ONDANSETRON","TAB 8MG ODT","30","Select","Select",""],["","00536408501","PRENATAL","TAB 28-0.8MG","30","Select","Select",""],["","69315012710","FOLIC ACID","TAB 1000MCG","90","Select","Select",""],["","00069034530","PAXLOVID","TAB 300-100","30","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","14","Select","Select",""],["","31722070430","VALACYCLOVIR","500 MG","60","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","00536408501","PRENATAL VITAMINS","28MG-0.8MG","30","Select","Select",""],["","65862039110","ONDANSETRON ODT","8 MG","30","Select","Select",""],["","69097083305","SERTRALINE HCL","25 MG","90","Select","Select",""],["","51991081701","PROPRANOLOL HCL ER","60 MG","90","Select","Select",""],["","50111056001","TRAZODONE HCL","50 MG","90","Select","Select",""],["","68462030529","NORETHINDRON TAB","0.35MG","84","Select","Select",""],["","50111056001","TRAZODONE TAB","50MG","90","Select","Select",""],["","51991081701","PROPRANOLOL CAP","60MG ER","90","Select","Select",""],["","69097083305","SERTRALINE TAB","25MG","30","Select","Select",""],["","42546026903","PRENATAL TAB LOW IRON","","90","Select","Select",""],["","65862039110","ONDANSETRON TAB","8MG ODT","30","Select","Select",""],["","00536408501","PRENATAL TAB","28-0.8MG","30","Select","Select",""],["","69315012710","FOLIC ACID TAB","1000MCG","90","Select","Select",""],["","10702025350","BUT\/APAP\/CAF TAB","","20","Select","Select",""],["","65862001501","AMOXICILLIN TAB","875MG","14","Select","Select",""],["","00069034530","PAXLOVID TAB","300-100","30","Select","Select",""],["","31722070430","VALACYCLOVIR TAB","500MG","60","Select","Select",""],["","49483060450","IBUPROFEN TAB","800MG","60","Select","Select",""],["","16571020106","DICLOFENAC SODIUM","75 MG","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":""}]}]}