{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JASMINE JANUARY","gend":1,"add":"1707 GLENVIEW ROAD","city":"RICHMOND","state":"VA","zip":"23222-9998","dob":"1998-04-16","age":"","mstatus":"","insh":"2375268*01","cliId":"","pno":8045174873,"cno":8045174873,"email":"","ename":"","eno":"","pphy":"DAUSCH, SUSAN M MD","ppno":8042829479,"pcpadd":"SUITE 100 7601 FOREST AVENUE,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23229-9998","pcpcounty":"","pcpid":"","pcpname":"West End Obstetrics & Gynecology, PC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8042829619,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","F41.9","F90.9","E66.01","E55.9","K21.9","E78.00","R73.03","Z68.43","O47.03","Z3A.31","U07.1","J02.9","K44.9","O69.81X0","O99.214","Z37.0","Z3A.37","R30.0","N39.0","I10.","G47.30","Z20.822","Z68.42","Z34.93","E66.9","Z68.41","R51.9","D13.5","R10.13","O80.","Z3A.00","I49.8","R63.5","Z79.899","R10.10","D64.9","E46.","R53.83","E53.9","Z13.1","R39.15","O99.891","Z3A.34","Z87.891"],"date":["2022-11-15","2023-02-23","2022-10-13","2023-02-24","2022-11-22","2023-02-23","2023-02-23","2023-02-09","2023-02-23","2021-07-17","2021-07-17","2021-12-29","2021-12-29","2022-12-06","2021-08-29","2021-08-29","2021-08-29","2021-08-29","2022-10-05","2022-10-05","2023-02-23","2023-02-23","2023-02-23","2023-02-23","2021-07-17","2022-10-05","2022-10-05","2021-12-29","2023-04-24","2023-04-24","2021-08-29","2021-08-29","2023-02-09","2022-12-06","2023-04-24","2023-04-24","2022-05-10","2022-05-10","2022-05-10","2022-05-10","2022-05-10","2022-10-05","2021-08-06","2021-08-06","2021-08-28"],"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":[["","43598075205","BUPROPION TAB","150MG SR","60","Select","Select",""],["","69238207801","PROPRANOLOL TAB","20MG","30","Select","Select",""],["","50111056001","TRAZODONE TAB","50MG","30","Select","Select",""],["","10702000350","PROMETHAZINE TAB","25MG","12","Select","Select",""],["","65862077685","MILI TAB","0.25\/35","84","Select","Select",""],["","43386016106","MISOPROSTOL TAB","200MCG","4","Select","Select",""],["","64380080707","IBUPROFEN TAB","800MG","30","Select","Select",""],["","68180032002","BUPROPN HCL TAB","300MG XL","30","Select","Select",""],["","70700011985","ESTARYLLA TAB","0.25-35","84","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","8","Select","Select",""],["","50228038060","QUETIAPINE TAB","50MG ER","30","Select","Select",""],["","10135062101","PHENAZOPYRID TAB","200MG","6","Select","Select",""],["","65862042005","SMZ\/TMP DS TAB","800-160","14","Select","Select",""],["","73302045601","ELLA TAB","30MG","1","Select","Select",""],["","69452015120","VITAMIN D","2 1250 MCG","8","Select","Select",""],["","57237007710","ONDANSETRON ODT","4 MG","15","Select","Select",""],["","00172572860","FAMOTIDINE","20 MG","30","Select","Select",""],["","00406324301","HYDROMORPHONE HCL","2 MG","12","Select","Select",""],["","42192033901","HYOSCYAMINE SULFATE","0.125 MG","30","Select","Select",""],["","73302045601","ELLA","30 MG","1","Select","Select",""],["","43598075205","BUPROPION","TAB 150MG SR","60","Select","Select",""],["","69238207801","PROPRANOLOL","TAB 20MG","30","Select","Select",""],["","60505265301","TRAZODONE","TAB 50MG","30","Select","Select",""],["","16729044416","BUPROPN HCL","TAB 300MG XL","30","Select","Select",""],["","70700011985","ESTARYLLA","TAB 0.25-35","84","Select","Select",""],["","65862077685","MILI","TAB 0.25\/35","84","Select","Select",""],["","43386016106","MISOPROSTOL","TAB 200MCG","4","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","12","Select","Select",""],["","50228038060","QUETIAPINE","TAB 50MG ER","30","Select","Select",""],["","10135062101","PHENAZOPYRID","TAB 200MG","6","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","14","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":""}]}]}