{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CARMEN M BOOKER","gend":1,"add":"2402 S KENMORE ROAD","city":"RICHMOND","state":"VA","zip":"23225-9998","dob":"1983-02-28","age":"","mstatus":"","insh":"6691463*01","cliId":"","pno":8043269317,"cno":8043269317,"email":"","ename":"","eno":"","pphy":"SYED, HUZAEFAH MD","ppno":8048289341,"pcpadd":"1001 E. LEIGH ST,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23298-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048271703,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E86.0","N82.4","C53.9","K51.90","Z45.2","Z79.899","Z43.2","N17.9","N39.0","I10.","Z85.41","Z79.01","Z79.891","E86.1","E87.5","N30.00","N89.8","R10.84","Z93.2","M79.89","D64.9","N30.90","F41.9","E86.9","D63.8","K51.213","Z86.718","Z87.891","Z90.49","Z95.828","R10.9","N32.1","R07.89","M54.9","M54.6","E83.52","R11.0","Z20.822","R59.1","R63.4","R53.83","R10.2","K58.9","K62.6","K94.19","K52.9","K91.850","R10.30","D86.9","R11.2","R94.31","K51.911","N17.0","E87.2","N18.9","I12.9","Z92.21","Z92.3","Z88.5","Z88.8","Z88.6","Z88.2","E87.6","N12.","E87.1","N82.3","Z98.891","M06.9","L29.9","G89.29","R19.5","R19.7","R74.01","R10.817","R07.9","M79.651","S16.1XXA","M25.512","N93.9","I89.9","R74.8","K62.5","R10.814","R10.811","R10.813","R53.1","U07.1","R07.81","F17.200","Z86.711","E44.0","D53.9","D50.9","F17.210","E53.8","R82.71","G89.3","E83.42","M05.79","D86.0","D86.89","D86.1","R76.8","R07.2","R10.33","R10.31","N81.84","Z87.440","NO DATA","R09.81","R43.9","R79.89","H53.8","Z04.9","R50.9","Z93.3"],"date":["2023-06-18","2021-08-06","2022-08-27","2021-08-06","2021-01-21","2021-01-21","2021-01-21","2022-04-16","2022-03-11","2023-06-21","2023-06-18","2021-01-21","2021-01-21","2021-01-28","2021-01-26","2021-02-27","2021-02-25","2023-06-21","2023-07-27","2022-06-21","2022-09-04","2022-08-27","2021-02-25","2021-02-25","2021-02-27","2021-02-25","2021-02-25","2022-08-27","2022-04-14","2023-06-18","2023-06-21","2021-03-09","2022-02-16","2022-02-16","2022-02-16","2023-01-19","2022-08-27","2022-08-27","2022-08-29","2022-08-29","2022-08-29","2021-03-25","2021-03-25","2021-01-06","2021-01-19","2021-01-19","2021-01-19","2021-06-08","2023-01-19","2023-06-21","2023-06-21","2021-01-25","2021-01-25","2022-08-28","2021-01-25","2021-01-25","2022-08-28","2023-06-18","2022-04-14","2022-04-14","2022-04-14","2021-01-25","2022-08-28","2021-02-19","2022-08-28","2022-08-28","2021-01-02","2022-08-28","2021-01-02","2021-01-02","2021-01-04","2023-06-18","2021-02-26","2021-01-07","2023-04-27","2021-01-27","2022-05-27","2022-05-27","2022-08-28","2022-09-01","2021-01-27","2021-01-27","2021-01-27","2021-01-27","2021-01-27","2021-01-20","2021-12-10","2021-12-10","2023-04-27","2022-04-14","2022-08-28","2022-08-28","2022-08-28","2022-08-28","2022-08-28","2022-08-28","2022-08-28","2022-08-28","2023-05-18","2023-05-18","2023-01-19","2023-01-19","2023-05-18","2021-01-17","2021-01-17","2021-01-26","2021-02-04","2021-03-25","2022-02-16","2021-12-04","2021-12-04","2022-08-29","2023-05-18","2023-04-27","2023-06-18","2023-06-18"],"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":[["","65862039010","ONDANSETRON","TAB 4MG ODT","15","Select","Select",""],["","59011041010","OXYCONTIN","TAB 10MG CR","20","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","55700033430","OXYCODONE","TAB 10MG ER","20","Select","Select",""],["","42858030101","HYDROMORPHON","TAB 2MG","10","Select","Select",""],["","60219107601","AZATHIOPRINE","TAB 50MG","45","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","00093005805","TRAMADOL HCL","TAB 50MG","6","Select","Select",""],["","00093031101","LOPERAMIDE","2 MG","240","Select","Select",""],["","75826011510","PHENAZOPYRID","TAB 200MG","6","Select","Select",""],["","68180012202","CEPHALEXIN","500 MG","14","Select","Select",""],["","65862053820","LEVOFLOXACIN","TAB 750MG","7","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","65862009620","CEFPODOXIME","TAB 200MG","28","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","20","Select","Select",""],["","00093342210","CYCLOBENZAPR","TAB 10MG","9","Select","Select",""],["","00603497528","OXYBUTYNIN","TAB 5MG","90","Select","Select",""],["","00555901658","SPRINTEC 28","TAB 28 DAY","28","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","90","Select","Select",""],["","00378041510","DIPHEN\/ATROP","TAB 2.5MG","270","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","68462030929","NORGEST\/ETHI","TAB 0.25\/35","28","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00591544310","PREDNISONE","TAB 20MG","20","Select","Select",""],["","80777027399","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","69584061250","METHOCARBAM","TAB 750MG","28","Select","Select",""],["","00536100901","FERROUS SULF","TAB 325MG","15","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","20","Select","Select",""],["","30768060693","VITAMIN B-12","TAB 1000MCG","30","Select","Select",""],["","69618001001","ACETAMIN","TAB 325MG","30","Select","Select",""],["","00093342210","CYCLOBENZAPRINE HCL","10 MG","9","Select","Select",""],["","70954068910","PROCHLORPERAZINE MALEATE","10 MG","15","Select","Select",""],["","80777027399","MODERNA VAC INJ COVID-","19","0","Select","Select",""],["","00093031101","LOPERAMIDE CAP","2MG","240","Select","Select",""],["","68180012101","CEPHALEXIN CAP","250MG","28","Select","Select",""],["","69584061250","METHOCARBAM TAB","750MG","28","Select","Select",""],["","00093342210","CYCLOBENZAPR TAB","10MG","9","Select","Select",""],["","30768060693","VITAMIN B-","12 TAB 1000MCG","30","Select","Select",""],["","00591352530","LIDOCAINE PAD","5%","20","Select","Select",""],["","00591544310","PREDNISONE TAB","20MG","20","Select","Select",""],["","00536100901","FERROUS SULF TAB","325MG","15","Select","Select",""],["","69618001001","ACETAMIN TAB","325MG","30","Select","Select",""],["","53746052101","PROMETHAZINE HCL","25 MG","20","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":""}]}]}