{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ADRIAN  D WRIGHT","gend":0,"add":"2122 BISHOP ST","city":"PETERSBURG","state":"VA","zip":"23805-9998","dob":"1986-08-22","age":"","mstatus":"","insh":"2311998*01","cliId":"","pno":8043246825,"cno":8043246825,"email":"","ename":"","eno":"","pphy":"ABBINENI, NIKHILA MD","ppno":8047338821,"pcpadd":"50 MEDICAL PARK BLVD STE C,","pcpcity":"PETERSBURG","pcpstate":"VA","pcpzip":"23805-9998","pcpcounty":"","pcpid":"","pcpname":"Bon Secours - Southside Internal Medicine","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048614365,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","I42.9","R79.89","R00.0","J96.00","I50.9","J18.9","I16.1","I11.0","I50.23","I50.30","I42.8","J96.01","I50.22","Z29.9","F41.1","I34.0","I51.7","I50.20","A41.9","I50.21","Z68.36","I50.31","Z09.","I10.","E78.00","Z68.39","F33.2","I42.0","F17.200","I16.0","R65.20","F33.3","J15.212","R06.82","Z20.822","E66.01","Z68.41","R73.03","F41.9","F17.210","D64.9","R59.0","Z53.29","Z79.82","I95.9","F15.90","G47.33","Z79.84","Z79.899","Z91.14","F32.2"],"date":["2022-06-22","2022-08-30","2022-12-06","2022-08-30","2022-08-30","2022-08-30","2022-11-29","2022-11-29","2023-05-19","2022-12-01","2022-12-02","2022-12-02","2022-12-02","2023-05-19","2023-05-19","2022-12-15","2022-08-25","2022-08-29","2022-12-03","2022-08-31","2022-12-06","2022-11-30","2022-12-01","2022-12-06","2022-12-06","2022-12-06","2022-12-06","2023-01-31","2022-10-02","2023-05-19","2022-12-03","2022-08-25","2021-05-16","2022-08-28","2022-08-30","2022-11-29","2022-11-29","2022-08-25","2022-08-25","2022-08-25","2022-08-25","2022-08-25","2022-08-25","2022-08-25","2022-11-29","2022-11-29","2022-11-29","2022-11-29","2022-11-29","2022-11-29","2022-11-29","2023-02-09"],"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":[["","70377000812","ROSUVASTATIN TAB","20MG","30","Select","Select",""],["","55513081060","CORLANOR TAB","7.5MG","60","Select","Select",""],["","00078065920","ENTRESTO TAB","24-26MG","60","Select","Select",""],["","00832054111","BUMETANIDE TAB","1MG","60","Select","Select",""],["","00597015230","JARDIANCE TAB","10MG","30","Select","Select",""],["","76385011150","CARVEDILOL TAB","6.25MG","60","Select","Select",""],["","24658031205","DOXYCYCL HYC TAB","100MG","10","Select","Select",""],["","43547040211","FUROSEMIDE TAB","40MG","60","Select","Select",""],["","55513081060","CORLANOR","7.5 MG","60","Select","Select",""],["","00597015230","JARDIANCE","10 MG","30","Select","Select",""],["","00536137223","NICOTINE GUM","4 MG","110","Select","Select",""],["","76385011150","CARVEDILOL","6.25 MG","60","Select","Select",""],["","00078065920","ENTRESTO","24 MG-26MG","60","Select","Select",""],["","00904675180","ASPIRIN EC","81 MG","30","Select","Select",""],["","43547040211","FUROSEMIDE","40 MG","60","Select","Select",""],["","43598044874","NICOTINE PATCH","21 MG\/24HR","14","Select","Select",""],["","70377000812","ROSUVASTATIN CALCIUM","20 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":""}]}]}