{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JANIYAH   N TRENT","gend":1,"add":"3510 CHAMBERLAYNE AVENUE","city":"RICHMOND                      ","state":"VA","zip":"23227-4551","dob":"2004-04-14","age":"","mstatus":"","insh":4169964,"cliId":"","pno":8044471884,"cno":"","email":"","ename":"","eno":"","pphy":"CAROLYN BOONE MD","ppno":8047838788,"pcpadd":"110 N Robinson St,Suite 103","pcpcity":"Richmond                      ","pcpstate":"VA","pcpzip":232204459,"pcpcounty":"","pcpid":"","pcpname":"CAROLYN J BOONE MD PC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"3510 CHAMBERLAYNE AVENUE","add3":"","madd1":"3510 CHAMBERLAYNE AVENUE","madd2":"APARTMENT S","madd3":"","mcity":"RICHMOND                      ","mstate":"VA","mzip":"23227-4551","pcpfaxno":8667776407,"pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H66.90","L70.9","Z68.52","Z71.82","Z71.3","R68.89","H92.03","G40.909","R07.9","D56.3","J45.909","Z77.22","Z00.121","D89.9","R80.2","R82.90","Z23","R42","R26.81","G40.401","R55","R56.9","N76.0"],"date":["2020-01-15","2021-08-19","2021-08-19","2021-08-19","2021-08-19","2021-01-14","2020-01-29","2020-10-09","2020-03-28","2020-03-28","2020-03-28","2020-03-28","2021-08-19","2021-08-19","2020-10-09","2020-10-09","2020-10-09","2021-01-14","2021-01-14","2021-04-05","2021-04-05","2021-04-05","2021-08-19"],"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":[["","59267100001","PFIZER","INJ COVID-19","0.3","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","2","Select","Select",""],["","53746051401","SPIRONOLACT","TAB 50MG","30","Select","Select",""],["","00378808645","TRETINOIN","GEL 0.00025","45","Select","Select",""],["","65862064169","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59762374301","CLINDAMYCIN","GEL 0.01","30","Select","Select",""],["","00143211250","DOXYCYCL","TAB 100MG","60","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","20","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":""}]}]}