{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  YADNASHTIMS E ","gend":1,"add":"IRO 5084EVA ELO","city":"RICHMOND","state":"VA","zip":"23234-9998","dob":"1958-07-16","age":"","mstatus":"","insh":"25300210*87","cliId":"","pno":"92\/4080711-9","cno":"","email":"","ename":"","eno":"","pphy":"CARTER, RENEE Y MD","ppno":"804\/560-8950","pcpadd":"9000 STONY POINT PARKWAY","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23235,"pcpcounty":"","pcpid":"","pcpname":"MCV ASSOCIATED PHYSICIANS","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M79.604","M79.605","F43.21","E78.5","R03.0","M54.9","R42.","F41.9","H00.14","L29.9","J18.9","R04.0","D72.829","R01.1","J45.909","E78.00","H10.13","J30.9","J44.9","F17.210","Z79.899","K21.9","J38.1","M54.12","M54.5","M54.2","N84.0","Q51.4","N85.00","N95.0","I10.","Q21.0","Z72.0","K76.0","F10.10","Z86.19","R91.8","J84.9","N93.9","R10.2","Z11.3","J43.9","R00.2","L73.9","L81.0","R06.09","J40.","H43.391","Z87.891","M25.552","A59.00","Z01.411","N89.8","M25.551","B18.2","M89.8X1","NO DATA","E78.2","I70.90","G89.29","Z11.59","R06.02","R07.9","J34.2","H25.13","H04.123","R05.","R91.1","M25.512","Z23.","H90.3","R49.0","Z20.828"],"date":["2019-09-11","2019-09-11","2019-08-27","2019-08-27","2019-08-27","2019-09-11","2019-10-10","2021-12-15","2019-09-11","2020-01-21","2020-02-02","2021-10-07","2020-01-21","2021-12-15","2020-01-21","2020-01-21","2021-12-15","2020-03-24","2021-12-17","2021-12-08","2020-03-24","2021-12-17","2020-12-03","2021-12-15","2019-08-22","2020-09-23","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-11-24","2021-11-24","2020-09-09","2021-12-08","2019-03-06","2020-06-18","2020-06-18","2021-10-14","2019-02-14","2019-05-31","2020-09-23","2019-05-17","2019-02-15","2019-05-03","2019-05-03","2021-05-26","2021-12-15","2019-09-17","2019-09-27","2019-09-27","2019-10-07","2021-11-24","2021-12-15","2021-12-15","2021-12-15","2021-12-15","2021-12-15","2021-12-15","2019-04-02","2019-04-02","2020-01-15","2020-06-26","2020-06-26","2020-10-31","2021-12-08","2020-09-23","2020-09-24","2020-11-13","2020-11-13","2021-09-05"],"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":[["","00093505698","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","30","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","90","Select","Select",""],["","","VENTOLIN"," VENTOLIN ","18","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","18","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","","FLUTIC\/SALME"," FLUTIC\/SALME ","60","Select","Select",""],["","","OLOPATADINE","SOL 0.002","","Select","Select",""],["","","SHINGRIX","INJ 50\/0.5ML","","Select","Select",""],["","16714008210","HYDROXYZ","TAB 25MG","120","Select","Select",""],["","49035061501","EQ","DRO 0.025%OP","5","Select","Select",""],["","00172392760","DIAZEPAM","TAB 10MG","1","Select","Select",""],["","17478071710","KETOTIF","DRO 0.025%OP","5","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","","VIRTUSSIN","SOL 100-10\/5","","Select","Select",""],["","","MONTELUKAST","TAB 10MG","","Select","Select",""],["","","ESOMEPRA","CAP 40MG DR","","Select","Select",""],["","","GG\/CODEINE","SOL 100-10\/5","","Select","Select",""],["","","APAP\/CODEINE","TAB 300-30MG","","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":""}]}]}