{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MOSES DANIEL","gend":0,"add":"5700 CASTLEBRIDGE ROAD                                      ","city":"FREDERICKSBURG                ","state":"VA","zip":"22407-6011","dob":"2004-03-11","age":"","mstatus":"","insh":3199407,"cliId":"","pno":5404290076,"cno":"","email":"","ename":"","eno":"","pphy":"KOST PHILLIPS, JENNIFER R                                   ","ppno":5403688091,"pcpadd":"331 Park Hill Dr                                            ,Ste 101                                                     ","pcpcity":"Fredericksburg                ","pcpstate":"VA","pcpzip":224013375,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"5700 CASTLEBRIDGE ROAD                                      ","add3":"","madd1":"5700 CASTLEBRIDGE ROAD                                      ","madd2":"APARTMENT 403                                               ","madd3":"","mcity":"FREDERICKSBURG                ","mstate":"VA","mzip":"22407-6011","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S41.102A","S51.002A","Y83.8","T81.89XA","Z88.2","Y83.4","F32.9","T84.619D","B95.61","Z98.890","M71.10","T81.49XA","M00.9","S42.409A","Z00.129","T84.619A","M70.22","Z79.2","M70.30","M25.429","L70.0","S42.392D","Z09","S59.909A","G44.1","Z03.818","J06.9","R53.83","R50.9","Z20.828","U07.1","M25.522","M67.813","R45.89","M25.512","M25.569","R07.9","Z00.00","Z23","R20.2","Z79.899","M21.961","M79.671","M79.672","M72.2"],"date":["2020-02-04","2020-02-10","2020-01-21","2020-01-17","2020-01-17","2020-02-04","2020-01-16","2020-01-30","2020-03-12","2020-03-12","2020-01-30","2020-01-31","2020-03-04","2020-02-10","2020-02-25","2020-03-12","2021-05-22","2020-03-12","2020-03-12","2020-03-21","2022-12-07","2020-08-10","2020-08-10","2020-08-10","2020-11-27","2021-03-31","2021-03-31","2021-03-31","2021-03-31","2021-03-31","2021-04-12","2021-11-13","2021-04-24","2022-03-14","2021-11-13","2021-11-13","2021-11-13","2022-03-14","2022-03-14","2022-07-19","2022-09-13","2022-09-19","2022-09-19","2022-09-19","2022-09-19"],"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":[["","00143314250","DOXYCYCL","CAP 100MG","60","Select","Select",""],["","45802028034","BENZOYL","LIQ 5% WASH","227","Select","Select",""],["","62332002331","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","45802084601","ADAPAL\/BEN","GEL 0.1-2.5%","45","Select","Select",""],["","55111011381","ZENATANE","CAP 30MG","30","Select","Select",""],["","00472011720","TRETINOIN","CRE 0.00025","20","Select","Select",""],["","59762374401","CLINDAMYCIN","LOT 10MG\/ML","60","Select","Select",""],["","24470090004","BP","LIQ 0.05","113","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0.3","Select","Select",""],["","61748001860","RIFAMPIN","CAP 300MG","28","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","68462018022","MUPIROCIN","OIN 0.02","22","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":""}]}]}