{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NAJAE WILLIAMS","gend":1,"add":"3338 COURTHOUSE RD APT G","city":"RICHMOND","state":"VA","zip":"23236-9998","dob":"1995-10-07","age":"","mstatus":"","insh":"5051150*01","cliId":"","pno":8044809379,"cno":8044809379,"email":"","ename":"","eno":"","pphy":"GRISWOLD, STEVEN MD","ppno":8044625155,"pcpadd":"36 LIVELY OAKS ROAD","pcpcity":"LIVELY","pcpstate":"VA","pcpzip":"22507-9998","pcpcounty":"","pcpid":"","pcpname":"Bon Secours Lively Medical Center","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8044625922,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R06.83","G47.10","E66.01","E78.5","E88.81","R11.0","E55.9","F43.10","F41.1","F33.1","L03.113","J45.909","F17.210","R06.2","R63.8","G47.00","F41.9","V58.89","T30.0","R73.03","N94.10","Z30.431","N85.00","N92.0","N76.0","G47.33","Z68.41","N93.9","T21.21XA","M62.9","R07.81","R06.02","F17.209","J45.21","Z32.02","N94.6","Z72.0","Z72.3","R53.83","I10."],"date":["2021-11-23","2021-11-23","2021-11-24","2023-01-09","2023-01-09","2022-04-27","2023-01-09","2022-08-16","2022-08-16","2022-10-01","2022-01-24","2022-01-24","2022-01-24","2022-01-24","2022-12-13","2022-12-13","2022-12-13","2022-02-23","2022-02-23","2023-03-01","2021-11-04","2021-09-28","2021-09-28","2021-11-04","2021-09-28","2022-07-25","2021-11-24","2022-02-05","2022-02-22","2021-11-30","2021-05-19","2021-05-19","2021-05-19","2021-05-19","2021-09-15","2021-11-04","2021-11-15","2021-11-15","2022-02-23","2022-02-23"],"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":[["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","68382091634","METHYLPRED","TAB 4MG","21","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","50111078710","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","9","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","20","Select","Select",""],["","00173068220","VENTOLIN HFA","AER ","18","Select","Select",""],["","80777027399","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","00168027740","CLINDAMYCIN","CRE 2% VAG","40","Select","Select",""],["","70710112307","DOXYCYC MONO","TAB 100MG","20","Select","Select",""],["","00555901858","TRI-SPRINTEC","TAB ","28","Select","Select",""],["","53746051501","SPIRONOLACT","TAB 100MG","90","Select","Select",""],["","70436001002","BUPROPN HCL","TAB 150MG XL","90","Select","Select",""],["","65162046935","ELURYNG","MIS ","1","Select","Select",""],["","68382080601","TRAZODONE","TAB 100MG","60","Select","Select",""],["","00406117003","NALTREXONE","TAB 50MG","60","Select","Select",""],["","80681017401","VITAMIN D3","CAP 1.25MG","12","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","00472110526","BACITR ZINC","OIN 500U\/GM","27","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","12","Select","Select",""],["","43598021055","SSD","CRE 0.01","50","Select","Select",""],["","59267102504","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","45802006070","BACITRACIN","OIN 500\/GM","30","Select","Select",""],["","16714008310","HYDROXYZ HCL","TAB 50MG","60","Select","Select",""],["","16714061304","SERTRALINE","TAB 100MG","90","Select","Select",""],["","42632002727","BLOOD PRESSU","MIS MONITOR","1","Select","Select",""],["","70010049110","METFORMIN","TAB 500MG ER","120","Select","Select",""],["","51663000500","OPTIMAL-D","CAP 50000UNT","8","Select","Select",""],["","69097012303","TOPIRAMATE","TAB 50MG","90","Select","Select",""],["","43547028111","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","70700012185","TRI-ESTARYLL","TAB ","84","Select","Select",""],["","51862056406","LOW-OGESTREL","TAB ","28","Select","Select",""],["","00093807316","KELNOR 1\/50","TAB ","84","Select","Select",""],["","00002318280","TRULICITY","4.5 MG\/0.5","2","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":""}]}]}