{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LISA RODENBO","gend":1,"add":"11200 WILLOW LANE","city":"DISPUTANTA                    ","state":"VA","zip":"23842-4549","dob":"1973-10-12","age":"","mstatus":"","insh":4121843,"cliId":"","pno":8044904298,"cno":8048925022,"email":"","ename":"","eno":"","pphy":"VILLANUEVA, JOHN G","ppno":8044525800,"pcpadd":"8380 BOYDTON PLANK ROAD,","pcpcity":"PRINCE GEORGE                 ","pcpstate":"VA","pcpzip":238751400,"pcpcounty":"","pcpid":"","pcpname":"HOPEWELL PRINCE GEORGE COMMUNITY HEALTH CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"11200 WILLOW LANE","add3":"","madd1":"11200 WILLOW LANE","madd2":"","madd3":"","mcity":"DISPUTANTA                    ","mstate":"VA","mzip":"23842-4549","pcpfaxno":"(804) 452-5801","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R05","R06.02","M79.674","M79.9","S93.501A","W01.0XXA","Y93.01","Y92.512","Z20.828","J44.9","F17.200","J06.9","S46.912A","I10","F17.210","X58.XXXA","M25.512","E07.9","Z88.5","Z88.8","M54.12","G56.22","R20.0","M54.2","R20.2","Z86.718","R21","K20.90","R10.13","R11.2","R07.2","K29.70","K62.89","R07.9","K85.90","R10.9","R11.0","R11.10","Z20.822","K76.0","R10.84","J44.1","L28.2","J81.1","T36.4X5A","T50.905A","M54.5","R31.9","S82.431A","S82.61XB","S91.001A","V48.4XXA","J96.01","E66.2","S82.51XB","S93.04XA","Z68.39","Z88.6","Z91.018","Z91.011","S82.891B","W18.39XA","S99.911A","W19.XXXA","F10.10","G47.33","S82.61XA","G89.18","S82.401A","M79.89","Z96.9","F33.2","M25.571","S90.01XA","W22.09XA","Y92.002","M85.80","Z83.3","Z82.49","W22.8XXA","F33.1","F32.2"],"date":["2021-06-03","2021-04-10","2020-10-27","2020-10-27","2020-10-27","2020-10-27","2021-06-30","2020-10-27","2020-10-27","2021-07-02","2021-06-30","2021-06-03","2020-12-23","2020-12-23","2021-10-10","2020-12-23","2020-12-23","2021-09-22","2021-10-10","2021-10-10","2020-12-25","2020-12-25","2020-12-25","2020-12-25","2020-12-25","2021-04-17","2021-04-06","2021-04-10","2021-04-17","2021-04-11","2021-04-10","2021-04-11","2021-04-10","2021-04-11","2021-06-20","2021-04-17","2021-06-02","2021-04-11","2021-06-30","2021-04-11","2021-04-17","2021-06-30","2021-05-30","2021-05-30","2021-06-02","2021-06-02","2021-06-20","2021-06-20","2021-06-30","2021-06-30","2021-06-30","2021-06-30","2021-07-02","2021-06-30","2021-06-30","2021-07-02","2021-06-30","2021-06-30","2021-06-30","2021-06-30","2021-06-30","2021-06-30","2021-06-30","2021-06-30","2021-07-02","2021-07-02","2021-07-02","2021-09-22","2021-07-21","2021-09-22","2021-07-21","2021-11-29","2021-10-10","2021-10-10","2021-10-10","2021-10-10","2021-10-10","2021-10-10","2021-10-10","2021-10-10","2021-11-21","2021-12-29"],"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":{"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":[["","67877024901","QUETIAPINE","TAB 50MG","30","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","18","Select","Select",""],["","16714008210","HYDROXYZ","TAB 25MG","40","Select","Select",""],["","42806031250","DOXYCYCL","TAB 100MG","20","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","50","Select","Select",""],["","00955100410","ENOXAPARIN","INJ 40\/0.4ML","2","Select","Select",""],["","50111078710","AZITHROMYCIN","TAB 250MG","5","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","21","Select","Select",""],["","43547028810","BUPROPION","TAB 100MG SR","30","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","49884068905","METOCLOPRAM","TAB 10MG","10","Select","Select",""],["","59762040101","SUCRALFATE","TAB 1GM","40","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","00406324301","HYDROMORPHON","TAB 2MG","6","Select","Select",""],["","62175011843","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","00363020765","ACID","TAB 10MG","60","Select","Select",""],["","00054350049","LIDOCAINE","SOL 2% VISC","200","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00378668999","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","62542030117","HYD","SUS 10-8\/5ML","60","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","10","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","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":""}]}]}