{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAIJAH BARNETTE","gend":1,"add":"4028 OLD BROOK RD APT A","city":"RICHMOND","state":"VA","zip":"23227-9998","dob":"1994-09-07","age":"","mstatus":"","insh":"2352616*01","cliId":"","pno":8049338829,"cno":8049338829,"email":"","ename":"","eno":"","pphy":"WEATHERFORD, SHANNON MD","ppno":8047410440,"pcpadd":"SUITE 228 7601 FOREST AVENUE,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23229-9998","pcpcounty":"","pcpid":"","pcpname":"OB-GYN Associates, Ltd.","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8042882277,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","F41.1","O99.011","Z3A.09","Z20.822","R42.","O99.511","O26.891","J45.909","F32.2","F33.9","O36.8330","O99.013","D64.9","O99.213","E66.01","O99.513","O13.3","Z3A.37","R10.2","O99.02","D50.9","Z37.0","Z3A.39","F31.81","I31.3","J95.821","J96.01","E87.1","I10.","R52.","Z3A.23","R10.84","Z3A.35","W18.30XA","F90.2","O99.212","Z68.43","V23.5","Z3A.21","O10.013","Z3A.34","O34.211","V23.7","O99.214","O69.81X0","O10.912","I34.0","R10.33","N39.0","F31.32","Z3A.29","R00.0","R06.02","I31.9","J45.998","O99.413","Z3A.28","Z39.1","Z34.82","Z34.83","I21.3","F17.200","O23.40","O99.210","Z3A.00","NO DATA","D64.89","I51.7","F33.0","M25.512","M25.511","M25.552","M25.551","M54.2","M54.9","Z68.41","Z79.51","Z04.9","M54.89","Z23.","O26.893","Z32.01","O16.1","O23.41","K08.89","O99.891","R68.84","O21.9","R35.0","H92.09","Z3A.13","H92.01","R51.9","O26.892","R10.31","O10.012","Z3A.24","O99.283","O34.219","O10.113","E53.8","R55.","I11.0","I50.9","Z91.199","O99.42","Z68.42","J30.2","F31.4","O99.52","O99.512","O16.2","Z3A.15","R09.81","O99.412","Z3A.20","Z87.09","G47.33","O36.8130","R10.9","O20.9","Z3A.32","O16.3","J45.901","E66.9","Z87.891","F41.9","R79.89","D72.829","E87.6","Z56.0","Z98.890","F31.9","Z3A.01","F43.10","I50.20","I07.1","I50.22","O99.12","D50.0","I08.1","K66.0","O16.4","I50.30","G43.919","H93.90","K02.9","K60.2","J45.20","R07.9","G43.019","K08.9","G43.909","K04.7","R31.9","R62.51"],"date":["2023-04-18","2023-04-15","2021-05-30","2021-05-30","2022-08-30","2022-12-05","2022-09-13","2021-06-02","2023-05-06","2021-01-14","2021-12-01","2021-11-26","2023-02-27","2022-05-12","2023-02-25","2023-03-13","2023-02-25","2021-11-26","2023-03-13","2021-12-01","2023-03-13","2023-02-25","2023-03-13","2021-12-07","2023-04-20","2022-05-16","2022-05-13","2022-05-16","2022-05-16","2023-05-06","2023-05-08","2022-12-05","2023-02-25","2023-02-25","2023-02-25","2021-05-16","2022-12-14","2023-07-12","2023-01-11","2022-11-17","2023-01-11","2021-11-04","2023-03-13","2021-12-07","2023-03-13","2021-12-07","2023-02-25","2023-03-16","2021-02-12","2021-02-12","2021-03-16","2021-09-27","2023-03-15","2022-05-12","2022-05-12","2022-05-16","2023-01-11","2023-01-11","2021-10-21","2021-10-21","2021-10-21","2022-05-11","2023-05-06","2022-08-30","2022-08-30","2023-03-13","2023-07-06","2023-02-25","2023-03-15","2021-01-03","2021-04-06","2021-04-06","2021-04-06","2021-04-06","2021-04-06","2021-04-06","2021-04-06","2021-04-06","2021-05-30","2021-10-04","2021-10-22","2023-02-25","2022-08-30","2022-09-13","2022-09-13","2023-07-12","2022-12-05","2023-04-25","2022-09-13","2022-09-13","2022-09-13","2022-09-13","2022-12-05","2023-05-08","2022-12-05","2022-12-05","2022-12-14","2022-12-14","2023-02-25","2023-03-13","2023-02-25","2023-02-25","2023-02-25","2023-03-13","2023-07-12","2023-02-25","2023-03-13","2023-04-25","2021-01-12","2021-05-26","2023-03-13","2022-12-05","2022-12-05","2022-10-06","2023-04-08","2022-11-16","2022-11-16","2022-11-17","2023-03-15","2023-01-11","2021-08-06","2021-08-07","2021-10-21","2021-12-06","2021-12-06","2023-07-12","2021-12-06","2022-05-11","2022-05-12","2023-03-13","2022-05-12","2022-05-12","2022-05-16","2022-05-22","2022-08-30","2022-01-11","2023-07-06","2023-03-16","2023-03-13","2023-03-13","2023-03-13","2023-03-13","2023-03-13","2023-03-13","2023-03-15","2023-04-08","2023-04-08","2023-07-12","2023-04-25","2022-11-16","2023-05-06","2023-05-06","2023-05-08","2023-05-06","2023-07-12","2023-07-12","2023-06-01"],"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":[["","52817033200","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","00713052612","PROMETHEGAN","SUP 25MG","15","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","15","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","45802010901","TRIAMCINOLON","AER 55MCG\/AC","17","Select","Select",""],["","00363081101","ALLERGY NASA","SPR 24HR","17","Select","Select",""],["","00378461501","DOXYL\/PYRID","TAB 10-10MG","90","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","15","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","76204020025","ALBUTEROL","NEB 0.00083","150","Select","Select",""],["","69097084905","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","00067012547","SLOW FE","TAB 160MG CR","30","Select","Select",""],["","23155050001","HYDROXYZ HCL","TAB 10MG","90","Select","Select",""],["","66689000802","NYSTATIN","100000\/ML","60","Select","Select",""],["","68180035202","SERTRALINE","TAB 50MG","30","Select","Select",""],["","10702005601","OXYCODONE","TAB 10MG","20","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","70954006020","PREDNISONE","20 MG","10","Select","Select",""],["","59651036205","IBUPROFEN","800 MG","20","Select","Select",""],["","00378108601","COLCHICINE","TAB 0.6MG","5","Select","Select",""],["","10702025350","BUT\/APAP\/CAF","TAB ","6","Select","Select",""],["","11917009215","FERROUS SULFATE","325(65) MG","90","Select","Select",""],["","57237007810","ONDANSETRON ODT","8 MG","30","Select","Select",""],["","00406055201","OXYCODONE HCL","5 MG","20","Select","Select",""],["","69097083412","SERTRALINE HCL","50 MG","30","Select","Select",""],["","57237004105","PENICILLIN V POTASSIUM","500 MG","21","Select","Select",""],["","00591264001","BUTALBITAL-ACETAMINOPHEN-CAFFE","50-300-40","20","Select","Select",""],["","00406012305","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","12","Select","Select",""],["","00781808926","AZITHROMYCIN","250 MG","6","Select","Select",""],["","00135057603","FLONASE ALLERGY RELIEF","50 MCG","15.8","Select","Select",""],["","16571020210","DICLOFENAC SODIUM","50 MG","30","Select","Select",""],["","00904515460","GUAIFENESIN","200 MG","12","Select","Select",""],["","00054350049","LIDOCAINE HCL VISCOUS","2 %","100","Select","Select",""],["","60505082901","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","00378113401","KETOROLAC TROMETHAMINE","10 MG","20","Select","Select",""],["","70954068910","PROCHLORPERAZINE MALEATE","10 MG","20","Select","Select",""],["","00116200116","CHLORHEXIDINE GLUCONATE","0.12 %","473","Select","Select",""],["","00378108601","COLCHICINE TAB","0.6MG","30","Select","Select",""],["","76204020025","ALBUTEROL NEB","0.083%","150","Select","Select",""],["","10702005601","OXYCODONE TAB","10MG","20","Select","Select",""],["","57237007710","ONDANSETRON TAB","4MG ODT","15","Select","Select",""],["","45802065087","LORATADINE TAB","10MG","15","Select","Select",""],["","00093314705","CEPHALEXIN CAP","500MG","21","Select","Select",""],["","50111033402","METRONIDAZOL TAB","500MG","4","Select","Select",""],["","10702025350","BUT\/APAP\/CAF TAB","","6","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":""}]}]}