{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HEATHER OVERBY","gend":1,"add":"681 HIOAKS RD STE J","city":"RICHMOND","state":"VA","zip":"23225-9998","dob":"1987-09-13","age":"","mstatus":"","insh":"2236009*01","cliId":"","pno":8043564558,"cno":8043564558,"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":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048195221,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.21","F25.1","F20.0","F41.1","F11.90","O99.322","O98.112","O98.312","O98.212","O98.412","Z3A.25","O42.913","Z37.0","Z3A.33","F31.4","NO DATA","F11.20","Z00.00","Z01.89","O09.523","O62.9","Z3A.30","Z3A.32","O98.819","O98.219","A74.9","P22.9","F33.1","V29.0","R06.03","Z00.111","R41.82","F19.129","F33.2","F31.9","F11.23","F14.929","O99.341","O99.891","R00.0","Z77.22","Z3A.00","F99.","O60.14X0","O98.22","O98.12","O99.324","F11.10","O98.82","Z20.822","O13.4","F17.200","O76.","O99.334","O99.62","F41.9","O99.344","F20.9","G47.9","R10.9","R61.","O47.9","Z33.1","Z30.430","O99.323","F14.10","F33.9","F90.2","F33.3","L23.9","B34.9","M54.6","E66.9","Z68.41","R51.9","S01.01XA","W18.30XA","S82.61XA","M25.571","F31.30"],"date":["2021-12-03","2021-12-28","2022-02-16","2023-08-04","2022-10-01","2022-08-09","2022-08-09","2022-08-09","2022-08-09","2022-08-09","2022-08-09","2022-10-03","2022-10-03","2022-10-03","2022-10-11","2023-08-04","2023-08-01","2021-08-03","2022-08-05","2022-09-13","2022-09-13","2022-09-13","2022-10-01","2022-10-01","2022-10-01","2022-10-01","2022-10-03","2022-06-27","2022-10-05","2022-10-17","2022-11-01","2021-11-15","2021-11-15","2022-03-14","2022-09-29","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2023-05-26","2022-09-29","2023-05-26","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-03-21","2022-08-02","2022-08-02","2022-08-02","2022-09-13","2022-09-13","2022-10-03","2022-10-03","2022-10-03","2021-09-24","2021-11-29","2022-03-21","2023-05-25","2023-05-26","2023-05-26","2023-07-18","2023-05-26","2023-05-26","2023-05-26","2023-05-26","2023-07-26","2023-07-18","2023-08-26"],"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":[["","65862001205","SERTRALINE","TAB 50MG","30","Select","Select",""],["","00115180301","HYDROXYZ PAM","CAP 25MG","45","Select","Select",""],["","00904645760","DOK","CAP 100MG","60","Select","Select",""],["","12496120803","SUBOXONE","8 MG-2 MG","14","Select","Select",""],["","00527133010","BACLOFEN","10 MG","90","Select","Select",""],["","68382080510","TRAZODONE","TAB 50MG","15","Select","Select",""],["","49483060450","IBUPROFEN","800 MG","30","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","00904699880","DOCUSATE SOD","CAP 100MG","30","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","29300011101","LAMOTRIGINE","TAB 25MG","46","Select","Select",""],["","00378876793","BUPREN\/NALOX","MIS 8-2MG","18","Select","Select",""],["","45802081184","NALOXONE HCL","SPR 4MG","2","Select","Select",""],["","49483034001","ACETAMIN","TAB 325MG","30","Select","Select",""],["","69547035302","NARCAN","SPR 4MG","2","Select","Select",""],["","00087040203","POLY-VI-SOL","SOL 50MG\/ML","50","Select","Select",""],["","43547040110","FUROSEMIDE","TAB 20MG","4","Select","Select",""],["","00603548332","PROPRANOLOL","TAB 20MG","28","Select","Select",""],["","65162027250","SMZ\/TMP DS","TAB 800-160","6","Select","Select",""],["","27241009990","DULOXETINE","CAP 60MG","30","Select","Select",""],["","62011028701","HM CLEARLAX","POW ","238","Select","Select",""],["","49483008010","SENNA-TIME","TAB 8.6MG","60","Select","Select",""],["","16714047802","AMOX\/K CLAV","TAB 875-125","6","Select","Select",""],["","62011012401","MILK OF MAGN","SUS 400\/5ML","355","Select","Select",""],["","00115180301","HYDROXYZINE PAMOATE","25 MG","90","Select","Select",""],["","27241009990","DULOXETINE HCL","60 MG","30","Select","Select",""],["","13107007901","TRAZODONE HCL","50 MG","30","Select","Select",""],["","00093506205","HYDROXYZINE HCL","50 MG","60","Select","Select",""],["","00603548332","PROPRANOLOL HCL","20 MG","28","Select","Select",""],["","59746017506","PREDNISONE","20 MG","21","Select","Select",""],["","65862039010","ONDANSETRON ODT","4 MG","15","Select","Select",""],["","47781035703","BUPRENORPHINE-NALOXONE","8 MG-2 MG","4","Select","Select",""],["","45802081184","NALOXONE HCL SPR","4MG","2","Select","Select",""],["","00904699880","DOCUSATE SOD CAP","100MG","60","Select","Select",""],["","12496120203","SUBOXONE MIS","2-0.5MG","10","Select","Select",""],["","65162046650","IBUPROFEN TAB","800MG","20","Select","Select",""],["","49483034001","ACETAMIN TAB","325MG","30","Select","Select",""],["","43547040110","FUROSEMIDE TAB","20MG","4","Select","Select",""],["","47781035603","BUPREN\/NALOX MIS","4-1MG","12","Select","Select",""],["","69547035302","NARCAN SPR","4MG","2","Select","Select",""],["","16714047802","AMOX\/K CLAV TAB","875-125","6","Select","Select",""],["","68382080510","TRAZODONE TAB","50MG","15","Select","Select",""],["","00087040203","POLY-VI-SOL SOL","50MG\/ML","50","Select","Select",""],["","65162027250","SMZ\/TMP DS TAB","800-160","6","Select","Select",""],["","62011012401","MILK OF MAGN SUS","400\/5ML","355","Select","Select",""],["","62011028701","HM CLEARLAX POW","","238","Select","Select",""],["","27241009990","DULOXETINE CAP","60MG","30","Select","Select",""],["","00603548332","PROPRANOLOL TAB","20MG","28","Select","Select",""],["","00115180301","HYDROXYZ PAM CAP","25MG","45","Select","Select",""],["","49483008010","SENNA-TIME TAB","8.6MG","60","Select","Select",""],["","12496010001","SUBLOCADE","100 MG\/0.5","0.5","Select","Select",""],["","72888001400","CYCLOBENZAPRINE HCL","10 MG","20","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":""}]}]}