{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EILUJNNUD ","gend":1,"add":"ILORAC1243TEERTS AN","city":"RICHMOND","state":"VA","zip":"23222-2906","dob":"1982-01-14","age":"","mstatus":"","insh":"1614135","cliId":"","pno":"2343430256","cno":5713708407,"email":"","ename":"","eno":"","pphy":"DAVIDSON, SHANNON R","ppno":8047440200,"pcpadd":"3000 WATERCOVE RD,","pcpcity":"Midlothian","pcpstate":"VA","pcpzip":"23112-3982","pcpcounty":"","pcpid":"","pcpname":"VIRGINIA PHYSICIANS INC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"3421CAROLINA STREET","add3":"","madd1":"6811 Paragon Pl","madd2":"","madd3":"","mcity":"Richmond","mstate":"VA","mzip":"23230-1648","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","F15.10","F32.2","R68.89","F17.210","F10.10","F14.10","F41.9","L98.9","K02.9","F33.2","R44.0","F19.10","F33.3","Z20.822","F19.20","M25.562","M25.552","S76.012A","W18.09XA","S83.92XA","S83.91XA","W01.0XXA","T07.XXXA","W18.49XA","Z20.828","R51.9","F17.290","Z53.8","F43.23","I49.8","I51.7","S22.42XA","R07.89","V89.2XXA","Y92.410","F17.200","R93.7","Z96.641","F33.1","F19.14","F14.20","F15.20","M00.9","Z90.710","Z88.5","F39","R45.850","R45.851","F43.9","M00.851","S00.11XA","Z91.81","M79.605","F25.0","M25.559","K21.9","L02.414","F32.A","D64.9","Z59.9","Z88.8","F15.14","Z59.00","F90.2","F15.90","Z68.20","F32.9","F10.20","R79.9","F31.10","F12.90","F20.9","R41.82","R44.3","R44.1","Z53.29","Z71.1","Z02.83","F19.90","Z86.59"],"date":["2023-06-01","2021-01-06","2021-02-04","2021-02-11","2023-04-29","2021-02-11","2022-05-26","2022-12-27","2021-03-22","2021-03-22","2022-01-17","2022-12-27","2021-12-16","2021-10-25","2022-12-27","2022-02-22","2021-05-31","2021-10-18","2021-05-31","2021-05-31","2021-05-31","2021-05-31","2021-05-31","2021-05-31","2021-05-31","2021-06-10","2021-06-10","2022-03-29","2021-08-19","2021-09-15","2021-09-25","2021-09-25","2021-09-25","2021-09-25","2021-09-25","2021-09-25","2022-01-20","2021-09-25","2021-09-25","2022-05-01","2021-10-18","2022-01-20","2021-10-25","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-25","2022-06-12","2022-03-02","2021-10-29","2021-12-09","2022-12-27","2021-12-06","2021-12-06","2021-12-06","2021-12-10","2021-12-16","2022-05-29","2023-04-29","2022-02-03","2022-02-03","2022-03-29","2022-03-29","2022-03-04","2023-04-29","2022-05-24","2022-12-27","2022-12-27","2022-12-27","2022-12-27","2022-12-27","2023-04-29","2023-04-29","2023-04-29"],"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":[["","68180031909","BUPROPN HCL","TAB 150MG XL","30","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","6","Select","Select",""],["","00115180401","HYDROXYZ PAM","CAP 50MG","90","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","14","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","68382080510","TRAZODONE","TAB 50MG","30","Select","Select",""],["","57237001930","DULOXETINE","CAP 60MG","60","Select","Select",""],["","63402030830","LATUDA","TAB 80MG","30","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","00406802003","BUPREN\/NALOX","SUB 8-2MG","2","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","7","Select","Select",""],["","00135024102","NICORETTE","GUM 2MGFRUIT","100","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","42806066301","BUSPIRONE","TAB 10MG","90","Select","Select",""],["","68382005001","MELOXICAM","TAB 7.5MG","8","Select","Select",""],["","69547035302","NARCAN","SPR","2","Select","Select",""],["","00536589688","NICOTINE TD","DIS 21MG\/24H","14","Select","Select",""],["","68001028103","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","00781717612","NALOXONE","SPR","2","Select","Select",""],["","60505009701","PAROXETINE","TAB 10MG","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":""}]}]}