{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  EUQINODSENOJ M ","gend":1,"add":"MAJ TS 2001D TPA TS SE","city":"RICHMOND","state":"VA","zip":"23220-9998","dob":"1992-07-25","age":"","mstatus":"","insh":"2545610*83","cliId":"","pno":"97\/4081878-9","cno":"","email":"","ename":"","eno":"","pphy":"DEBOER, SARAH E MD","ppno":"804\/780-0840","pcpadd":"719 N 25th St","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23223,"pcpcounty":"","pcpid":"","pcpname":"VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER","plan":"OHP","program":"MEDICAID","lob":"M4","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":["F33.0","Z76.0","F17.210","R10.9","K20.0","O21.9","F33.1","R10.819","O34.212","Z3A.37","O34.219","Z3A.38","Z37.0","O99.52","J45.909","O99.344","F31.9","O99.334","Z20.822","Z30.017","O99.62","K21.9","Z83.3","Z82.62","Z82.49","Z82.3","O99.341","O99.611","K59.00","O99.511","Z87.891","Z3A.11","O90.89","Z98.891","R07.9","F31.81","F41.9","Z01.411","N93.9","R00.0","R14.0","R11.2","O9A.219","S76.911A","O99.519","O99.330","Z79.899","Z3A.00","M79.604","V23.5","O26.893","O62.9","O99.333","Z23.","Z3A.34","O34.211","O76.","G89.18","R19.7","Z34.83","Z3A.35","O32.1XX0","Z3A.36","Z33.1","R04.2","R19.5","J45.21","Z71.6","Z88.6","J45.901","Z34.90","F39.","F10.14","O82.","G50.1","W01.10XA","O42.913","D62.","O99.03","J45.30","O99.02","O41.03X0","K08.89","F17.200","J11.1","Z30.42","Z32.02","F41.1","F32.9","M54.5","Z48.817","N99.89","R10.30","Z51.89","K02.9","M27.3","R07.89","O86.00","R10.2","R00.2","J18.9","Z30.46","Z30.09","Z30.013"],"date":["2020-02-28","2020-07-03","2021-11-23","2021-11-30","2021-05-20","2021-05-20","2021-05-20","2021-05-20","2021-11-11","2021-11-11","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-11-30","2021-11-25","2021-11-23","2021-11-23","2021-11-30","2021-11-23","2021-11-23","2021-11-23","2021-05-14","2021-05-14","2021-06-22","2021-05-14","2021-05-14","2021-05-14","2021-11-30","2021-11-30","2021-11-30","2020-11-19","2022-03-03","2020-11-17","2020-11-17","2020-12-25","2021-06-22","2021-06-22","2021-07-27","2021-07-27","2021-07-27","2021-07-27","2021-07-27","2021-07-27","2021-07-27","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2021-11-23","2021-11-23","2021-11-30","2020-07-22","2021-10-28","2021-10-28","2021-11-04","2021-11-04","2021-11-04","2020-06-10","2020-06-10","2020-12-08","2020-12-08","2020-12-08","2020-12-25","2021-11-19","2022-03-03","2022-03-03","2021-11-23","2019-08-07","2019-08-07","2019-01-03","2019-01-03","2019-01-03","2019-01-03","2019-01-03","2019-01-04","2019-03-09","2019-02-27","2019-11-21","2019-12-10","2022-06-02","2019-09-26","2019-09-26","2019-01-24","2019-01-30","2019-01-23","2019-01-23","2019-01-30","2019-03-09","2019-03-21","2019-05-26","2019-02-01","2019-02-01","2019-05-26","2019-11-21","2022-06-02","2022-06-02","2022-06-02"],"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":[["","69584009150","BUSPIRONE","TAB 5MG","90","Select","Select",""],["","","QUETIAPINE","TAB 50MG","","Select","Select",""],["","","HYDROXYZ","CAP 25MG","","Select","Select",""],["","00703680101","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","57896045401","GERI-KOT","TAB 8.6MG","100","Select","Select",""],["","29033000301","SUCRALFATE","TAB 1GM","30","Select","Select",""],["","63304069201","CLINDAMYCIN","CAP 150MG","40","Select","Select",""],["","45802086803","POLYETH","POW 3350 NF","510","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","60432026415","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","63402030430","LATUDA","TAB 40MG","30","Select","Select",""],["","51660093901","CETIRIZINE","TAB 10MG","90","Select","Select",""],["","10006070012","VITAMIN","TAB 50MG","30","Select","Select",""],["","10135031401","SENNA","TAB 8.6MG","100","Select","Select",""],["","","PREDNISONE","TAB 20MG","","Select","Select",""],["","58602075521","PAIN","TAB 500MG","20","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","60","Select","Select",""],["","50428028552","ACETAMINOPHN","TAB 500MG","20","Select","Select",""],["","00093117401","PENICILLN","TAB 500MG","28","Select","Select",""],["","","RA","TAB 325MG","","Select","Select",""],["","","PROMETHEGAN","SUP 25MG","","Select","Select",""],["","","CAPSAICIN","CRE 0.00025","","Select","Select",""],["","","GAVILYTE-G","SOL ","","Select","Select",""],["","","LORAZEPAM","TAB 0.5MG","","Select","Select",""],["","","PHENADOZ","SUP 25MG","","Select","Select",""],["","","ZINC","TAB 50MG","","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","","METHOCARBAM","TAB 750MG","","Select","Select",""],["","","PSEUDOEPHEDR","TAB 120MG ER","","Select","Select",""],["","","ACETAMINOPHE","TAB 500MG","","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","30","Select","Select",""],["","50111078710","AZITHROMYCIN","TAB 250MG","4","Select","Select",""],["","65162004710","OXYCODONE","TAB 5MG","20","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","56","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","00781214501","AMPICILLIN","CAP 500MG","21","Select","Select",""],["","65162062710","TRAMADOL","TAB 50MG","10","Select","Select",""],["","65162003311","APAP\/CODEINE","TAB 300-30MG","16","Select","Select",""],["","00591079501","DICYCLOMINE","TAB 20MG","20","Select","Select",""],["","53746027201","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","31722063231","OSELTAMIVIR","CAP 75MG","10","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":""}]}]}