{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOYCE ELLIOTT","gend":1,"add":"8507 DEBBS LANE","city":"NORTH CHESTERFIEL             ","state":"VA","zip":"23235-6221","dob":"1990-12-17","age":"","mstatus":"","insh":1650125,"cliId":"","pno":8045162349,"cno":"","email":"","ename":"","eno":"","pphy":"BROOKS-WILLIAMS, MALINDA","ppno":8047800840,"pcpadd":"4730 N Southside Plaza St,","pcpcity":"Richmond                      ","pcpstate":"VA","pcpzip":232241742,"pcpcounty":"","pcpid":"","pcpname":"BERMUDA DISTRICT MEDICAL CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"8507 DEBBS LANE","add3":"","madd1":"8507 DEBBS LANE","madd2":"","madd3":"","mcity":"NORTH CHESTERFIEL             ","mstate":"VA","mzip":"23235-6221","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["A60.09","R59.0","Z11.3","N64.4","Z34.90","Z32.01","N76.6","O36.80X0","O20.9","Z86.19","Z98.890","Z30.09","R22.30","R22.32","O02.0","Z72.51","C58","N20.0","R22.2","Z01.419","B37.3","A53.9","N89.8","E04.9","O01.9","Z51.11","J01.40","R10.2","N76.0","A49.8","R35.0","R10.31","Z20.828","N92.1","Z87.59","N93.8","F33.9","J01.00","J00","N63.32","Z01.411"],"date":["2020-01-31","2020-01-31","2020-05-01","2020-01-31","2020-01-31","2020-05-01","2020-02-04","2020-02-28","2020-02-20","2020-05-01","2020-02-28","2020-02-28","2020-03-05","2020-03-05","2020-05-08","2020-05-01","2021-07-07","2020-06-15","2020-06-15","2021-11-08","2021-11-08","2020-06-18","2021-02-03","2020-06-18","2020-06-18","2020-06-25","2020-09-08","2020-12-30","2021-02-03","2020-11-11","2020-11-11","2020-11-12","2021-10-01","2021-02-03","2021-02-03","2021-06-09","2021-12-22","2021-10-01","2021-10-01","2021-11-08","2021-11-08"],"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":[["","00378808245","TRETINOIN","CRE 0.00025","45","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","4","Select","Select",""],["","45802073684","CLINDAMY\/BEN","GEL 1.2-5%","45","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","51224012230","AZITHROMYCIN","TAB 500MG","6","Select","Select",""],["","00603533932","PREDNISONE","TAB 20MG","21","Select","Select",""],["","00430042014","LO","TAB 40452","28","Select","Select",""],["","61570007401","MENEST","TAB 1.25MG","28","Select","Select",""],["","70700011985","ESTARYLLA","TAB 0.25-35","84","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","20","Select","Select",""],["","42806031250","DOXYCYCL","TAB 100MG","28","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","68462010630","ONDANSETRON","TAB 8MG","30","Select","Select",""],["","00378427577","VALACYCLOVIR","TAB 500MG","30","Select","Select",""],["","44567031110","PENICILLN","INJ 5MU","1","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","40","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","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":""}]}]}