{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EETNUAEKEILLOH ","gend":1,"add":"BSOM 827TEERTS Y","city":"RICHMOND","state":"VA","zip":"23223-6332","dob":"1998-10-22","age":"","mstatus":"","insh":"70019351","cliId":"","pno":"0540856177","cno":8046991861,"email":"","ename":"","eno":"","pphy":"VCU CENTER FOR ADVANCED HEALTH","ppno":"","pcpadd":"MCV Physicians, 2116 W Laburnum Ave Ste 100","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232274359,"pcpcounty":"","pcpid":"","pcpname":"VCU CENTER FOR ADVANCED HEALTH-SL","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"CENTRAL","aligned":"","ano":"","add2":"APARTMENT K","add3":"","madd1":"3706 Delmont St Apt 104","madd2":"","madd3":"","mcity":"Richmond","mstate":"VA","mzip":"23222-2072","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O99.331","F17.210","Z3A.11","Z33.1","O36.80X0","Z36.82","O9A.211","S00.12XA","M54.9","R10.9","Y04.0XXA","Z3A.12","R68.89","O9A.311","Z23","R05","R06.02","B97.89","Z3A.21","M79.10","F33.1","Z36.3","Z3A.23","F33.3","O47.03","O26.893","O99.343","F32.9","F43.10","F90.2","O99.513","J45.909","O99.213","E66.9","Z3A.31","Z62.810","Z87.891","Z83.3","O26.853","Z3A.36","O46.8X3","N93.9","N85.8","Z79.51","Z36.85","O99.344","Z37.0","Z3A.37","O99.52","O99.824","Z30.46","Z81.8","Z82.49","Z91.5","O80","Z39.1","N76.0","Z11.3","N98.8","L29.8","F32.89","N89.8","Z12.4","R87.613","D06.9","N72","R87.623","Z59.0","I10","Z92.29","Z13.31","R79.89","R79.9","E55.9","E53.8","Z79.899","H93.299","H53.8","R10.32","R11.0","F17.200","O20.9","N30.90","Z32.02","Z65.1","Z30.011","A64","R39.15","Z01.419","Z20.2","N92.6","R10.30","Z79.52","Z85.41","F33.2","A74.9","R56.9","Z53.21","R50.9","R10.2","B20","S62.655A","M79.645","W01.0XXA","M79.646","W19.XXXA","Y92.9","Z21","S62.625A","X58.XXXA","R30.0","B96.89","Z87.42","Z34.83","Z3A.26","O26.892","R10.10","Z3A.27","M94.0","O99.89","O99.332","Z60.8","Z3A.28","Z3A.30","Z3A.33","J45.20","F41.9","O99.333","F17.290","F12.90","O60.03","Z3A.35","O47.1","O99.323","F12.20","O99.820","Z3A.38","Z60.9","Z3A.39","O99.324","F41.8","Z72.0","Z41.2","S09.90XA","F33.0","N30.01","K59.00","R10.12","N39.0","B37.3","R10.33","M54.5","N30.00","Z32.00","Z32.01","R09.81","R52","R09.89","R11.10"],"date":["2020-01-21","2022-02-19","2020-01-21","2020-05-12","2020-01-21","2020-01-22","2020-01-26","2020-01-26","2020-01-26","2020-07-14","2020-01-26","2020-01-30","2021-01-11","2020-01-30","2020-05-12","2020-03-31","2021-01-11","2020-03-31","2020-03-31","2020-03-31","2020-04-30","2020-04-16","2020-04-16","2020-04-28","2020-07-14","2020-07-14","2020-07-14","2021-10-04","2021-01-11","2020-07-23","2020-07-14","2022-02-19","2020-06-05","2020-07-14","2020-06-05","2020-07-23","2020-07-14","2020-07-23","2020-07-14","2020-07-14","2020-07-14","2021-01-25","2020-07-14","2020-07-14","2020-07-14","2020-07-23","2020-07-24","2020-07-24","2020-07-23","2020-07-23","2020-12-14","2020-07-23","2020-07-23","2020-07-23","2020-07-24","2020-07-25","2022-02-19","2022-03-14","2020-08-23","2020-08-23","2020-08-25","2020-10-26","2022-03-14","2020-10-26","2020-11-09","2021-04-22","2020-10-26","2021-01-11","2021-01-11","2021-01-11","2021-01-11","2021-01-11","2021-01-11","2021-01-11","2021-01-11","2022-02-19","2021-01-11","2021-01-11","2021-01-25","2021-01-25","2021-10-21","2021-01-25","2021-03-26","2021-09-20","2021-03-26","2021-03-26","2021-03-26","2022-02-19","2022-03-14","2021-04-22","2021-04-22","2021-04-22","2021-04-22","2021-04-22","2021-07-26","2021-06-24","2021-07-22","2021-09-17","2021-09-17","2022-02-19","2021-11-01","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2022-02-19","2021-11-08","2021-11-08","2022-02-19","2022-02-19","2022-03-14","2019-04-05","2019-01-16","2019-01-19","2019-01-19","2019-01-19","2019-01-19","2019-01-19","2019-01-19","2019-01-31","2019-01-31","2019-02-14","2019-03-06","2019-04-12","2019-03-06","2019-03-31","2019-03-06","2019-04-12","2019-03-06","2019-03-15","2019-03-31","2019-03-31","2019-03-31","2019-03-31","2019-04-05","2019-04-05","2019-04-13","2019-04-12","2019-04-12","2019-04-12","2019-04-14","2019-04-15","2019-04-29","2019-10-04","2019-08-06","2019-08-06","2019-08-18","2019-08-18","2019-08-18","2019-08-18","2019-09-21","2019-10-04","2019-12-23","2019-12-23","2019-12-23","2019-12-23","2019-12-23"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","59779076678","PAIN","TAB 325MG","90","Select","Select",""],["","00555901658","SPRINTEC","TAB 28 DAY","28","Select","Select",""],["","00904585440","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","6","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","50428027137","CVS","TAB 27-0.8MG","30","Select","Select",""],["","13668001005","CITALOPRAM","TAB 20MG","45","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","63044015001","PRENATAL","TAB LOW IRON","30","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473.00","Select","Select",""],["","59779054462","ARTHRTS","TAB 650MG","20.00","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","20","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","18","Select","Select",""],["","68180016106","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","49281042050","FLUZONE","INJ 2020-21","0.5","Select","Select",""],["","50428053560","SERIES","MIS BLOOD PR","1","Select","Select",""],["","61958250101","BIKTARVY","TAB ","30","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","90","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","24658031205","DOXYCYCL","TAB 100MG","14","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","10","Select","Select",""],["","60432060816","PROMETHAZINE","SYP 6.25\/5ML","118","Select","Select",""],["","68462030529","NORETHINDRON","TAB 0.35MG","28","Select","Select",""],["","00603533815","PREDNISONE","PAK 10MG","21","Select","Select",""],["","53746027205","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","00904630477","MAG","SOL LEMON","296","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","00591079501","DICYCLOMINE","TAB 20MG","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":""}]}]}