{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TASHEDA  C SCOTT","gend":1,"add":"2921 KANE ST","city":"RICHMOND","state":"VA","zip":"23223-9998","dob":"1975-02-04","age":"","mstatus":"","insh":"2463462*01","cliId":"","pno":8047092962,"cno":8047092962,"email":"","ename":"","eno":"","pphy":"ELLIOTT, CHARMAINE N MD","ppno":8046441665,"pcpadd":"SUITE 308 1510 N 28TH STREET","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23223-9998","pcpcounty":"","pcpid":"","pcpname":"Primary Healthcare Associates","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8046445285,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R60.0","R31.9","R80.9","Z86.79","Z86.718","E11.9","I11.0","I50.9","Z86.73","M79.89","I63.50","R51.9","D64.9","R20.0","N93.9","E11.22","I10.","Z12.4","Z79.4","R07.9","R10.84","R22.43","N89.8","Z11.3","G82.50","NO DATA","E11.65","R79.89","R00.0","Z68.42","R63.5","E03.9","Z98.890","M51.26","M51.36","F41.0","I63.9","I82.4Y9","Z79.82","Z79.02","Z79.899","Z79.01","Z85.3","R10.30","D50.0","D68.59","I12.9","N18.9","E66.9","Z20.822","Z88.5","Z88.0","Z88.6","Z91.040","D50.9","R07.89","I69.398","G43.709","I65.02","H53.9","Z68.41","R20.2","G43.009","D53.0","R00.2","E83.42","M79.661","R79.1","M25.561","R42.","R06.02","F31.9","F20.9","I16.0","E13.649","I67.4","M54.81","J02.9","F41.8","N18.4","E66.01","K06.1","T88.7XXA","R03.0","R55.","I69.30","I67.89","G45.9","R60.9","F12.90","R53.1","R52.","Z79.891","M79.606","I66.22","R79.82","N28.9","Z92.89","E11.69","I65.23","N91.2","Z32.02","R30.0","N76.0","Z30.09","M25.512","N17.9","H53.461","G93.89","E78.2","G43.109","R29.702","E79.0","F41.9","E78.5","Z85.841","N85.8","Z79.890","B96.89","Z04.9","I63.332","H53.2","H53.453","E10.9","H25.13","R79.83","R10.13","R07.81","U07.1","A08.39","G43.909","G47.33","G93.2"],"date":["2022-04-27","2022-03-14","2022-03-28","2022-03-14","2023-01-23","2023-02-05","2023-01-23","2023-01-23","2023-01-23","2023-03-07","2022-07-13","2023-02-05","2022-08-11","2023-02-05","2022-12-01","2023-03-23","2023-03-23","2022-08-04","2022-12-06","2022-10-07","2022-10-07","2022-10-07","2022-12-01","2022-12-01","2023-02-07","2023-03-23","2022-05-16","2022-12-06","2023-02-08","2022-10-11","2022-05-16","2023-01-23","2023-03-07","2022-09-02","2023-03-07","2022-05-16","2023-04-21","2023-03-07","2022-08-11","2022-07-05","2022-08-18","2022-08-18","2023-01-23","2022-07-05","2023-02-20","2023-02-06","2023-03-23","2023-02-05","2022-08-04","2022-08-04","2022-08-04","2022-08-04","2022-08-04","2022-08-04","2023-02-06","2022-10-07","2023-01-06","2023-01-06","2023-01-06","2023-01-06","2023-03-07","2023-02-05","2023-02-07","2023-02-05","2022-03-08","2022-06-16","2022-06-16","2022-07-11","2022-07-28","2023-01-23","2022-11-09","2022-03-13","2022-03-13","2022-02-18","2022-02-22","2022-02-22","2022-05-02","2022-07-28","2023-03-07","2022-12-06","2023-02-06","2022-07-28","2022-12-30","2023-01-23","2023-02-05","2023-04-21","2023-03-07","2023-02-07","2022-03-14","2022-08-31","2023-02-05","2022-09-14","2022-10-11","2023-03-07","2022-08-31","2022-04-27","2022-04-27","2022-08-18","2022-08-18","2022-08-31","2022-10-18","2022-10-18","2022-10-18","2022-10-26","2022-10-18","2022-12-06","2023-02-06","2023-02-06","2023-02-06","2023-02-06","2023-02-06","2023-02-06","2023-02-06","2023-02-06","2023-01-23","2023-01-23","2022-08-18","2022-08-18","2022-10-26","2022-12-27","2022-02-03","2022-02-03","2022-03-07","2022-03-07","2022-03-07","2022-06-13","2022-09-14","2022-11-09","2022-11-09","2022-11-09","2023-01-17","2023-04-21","2023-04-21"],"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":[["","00904679489","ASPIRIN LOW","CHW 81MG","30","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","70377003012","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","65862035790","CLOPIDOGREL","TAB 75MG","30","Select","Select",""],["","00406052305","OXYCOD\/APAP","TAB 10-325MG","60","Select","Select",""],["","00002831501","HUMULIN N","100\/ML","40","Select","Select",""],["","76385011350","CARVEDILOL","25 MG","180","Select","Select",""],["","00228212810","CLONIDINE","TAB 0.2MG","90","Select","Select",""],["","00002821501","HUMULIN R","100\/ML","20","Select","Select",""],["","00169183311","NOVOLIN R","INJ U-100","30","Select","Select",""],["","31722053001","TORSEMIDE","TAB 10MG","30","Select","Select",""],["","57237004705","DIVALPROEX","TAB 250MG DR","60","Select","Select",""],["","16729022517","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","00093321205","CLONAZEPAM","1 MG","90","Select","Select",""],["","56151146001","TRUE METRIX","TES GLUCOSE","100","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","08290328418","INSULIN SYRG","MIS 1ML\/31G","100","Select","Select",""],["","69238183007","LEVOTHYROXIN","TAB 25MCG","90","Select","Select",""],["","50458057930","XARELTO","20 MG","90","Select","Select",""],["","00002143480","TRULICITY","INJ 1.5\/0.5","2","Select","Select",""],["","68382097001","CHLORTHALID","TAB 25MG","30","Select","Select",""],["","59746011306","PROCHLORPER","TAB 5MG","12","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","90","Select","Select",""],["","00832105410","BACLOFEN","TAB 10MG","30","Select","Select",""],["","10702025350","BUT\/APAP\/CAF","TAB ","15","Select","Select",""],["","68180016106","AZITHROMYCIN","TAB 500MG","5","Select","Select",""],["","00555077902","MEDROXYPR AC","TAB 10MG","90","Select","Select",""],["","46122065203","GNP ANORCTAL","CRE 0.05","28","Select","Select",""],["","67877056310","METFORMIN","TAB 1000MG","90","Select","Select",""],["","23155000810","HYDROCHLOROT","TAB 25MG","10","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","00536100901","FERROUS SULF","TAB 325MG","30","Select","Select",""],["","00310621030","FARXIGA","TAB 10MG","30","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","00603211532","ALLOPURINOL","100 MG","90","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","62559049001","DIPHEN\/ATROP","TAB 2.5MG","20","Select","Select",""],["","69452015120","VITAMIN D","2 1250 MCG","12","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","31722095801","BENZONATATE","CAP 200MG","21","Select","Select",""],["","00093216568","NALOXONE HCL","SPR 4MG","2","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","72578008804","NYSTAT\/TRIAM","OIN ","30","Select","Select",""],["","70954006020","PREDNISONE","TAB 20MG","5","Select","Select",""],["","70377003012","ATORVASTATIN CALCIUM","80 MG","90","Select","Select",""],["","69097012303","TOPIRAMATE","50 MG","30","Select","Select",""],["","53746051101","SPIRONOLACTONE","25 MG","90","Select","Select",""],["","00228212910","CLONIDINE HCL","0.3 MG","90","Select","Select",""],["","00406052305","OXYCODONE-ACETAMINOPHEN","10MG-325MG","60","Select","Select",""],["","69238115409","EZETIMIBE","10 MG","90","Select","Select",""],["","08290328418","INSULIN SYRINGE","31 GX5\/16\"","100","Select","Select",""],["","33342017807","OLMESARTAN MEDOXOMIL","5 MG","90","Select","Select",""],["","70377000911","ROSUVASTATIN CALCIUM","40 MG","90","Select","Select",""],["","62332002791","LOSARTAN POTASSIUM","25 MG","30","Select","Select",""],["","56151146001","TRUE METRIX GLUCOSE TEST STRIP","","100","Select","Select",""],["","50111056101","TRAZODONE HCL","100 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":""}]}]}