{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JESSICA BEAMER","gend":1,"add":"1951 CROSS CREEK ROAD","city":"HILLSVILLE","state":"VA","zip":"24343-5491","dob":"1986-10-20","age":"","mstatus":"","insh":4211036,"cliId":"","pno":2767334993,"cno":"","email":"","ename":"","eno":"","pphy":"ABBASI, GOHAR MAQSOOD","ppno":8045305293,"pcpadd":"1714 E Hundred Rd, Ste 101","pcpcity":"Chester","pcpstate":"VA","pcpzip":238363310,"pcpcounty":"","pcpid":"","pcpname":"HENRICO HEALTH & REHABILITATION CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"1951 CROSS CREEK ROAD","madd2":"","madd3":"","mcity":"HILLSVILLE","mstate":"VA","mzip":"24343-5491","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R00.2","F17.200","L02.415","N89.8","N39.0","R10.9","K21.9","R10.13","E87.5","Z20.2","R06.09","E87.6","J45.909","R07.2","R06.02","R07.89","R06.00","M25.50","R07.9","Q24.9","R07.0","R53.83","A69.20","K92.2","K92.1","D64.9","K29.71","D56.1","E87.70","D50.0","Z20.828","K31.7","K63.5","K64.8","N92.0","Z87.891","K29.50","K21.00","R19.7","T18.2XXA","D12.5","I08.1","R13.19","Z75.8","Z87.19","R10.11","Z01.411","R10.2","N85.2","Z11.51","Z11.3","Z11.8","R87.810","I47.1","E83.39","Z86.19","F17.210","E83.42","F41.9","F41.8","N30.00","R06.2","R07.81","R11.0","R94.31","U07.1","M54.50","R05.3","M54.2","M54.6","M51.35","M50.30","R05.9","J32.9"],"date":["2020-12-14","2020-11-12","2020-09-20","2020-09-20","2020-09-22","2020-10-24","2020-09-22","2021-03-24","2020-10-13","2020-10-19","2020-11-05","2020-12-15","2020-10-17","2020-10-17","2021-03-25","2021-03-25","2022-03-23","2020-10-19","2021-12-03","2020-10-21","2020-10-22","2020-10-22","2020-10-25","2020-10-25","2020-10-25","2020-12-02","2020-10-25","2020-10-25","2020-10-25","2020-12-02","2020-10-25","2020-10-26","2020-10-26","2020-10-25","2020-12-02","2021-03-24","2020-10-25","2020-10-25","2020-10-26","2020-10-25","2020-10-26","2020-10-26","2020-10-26","2020-11-11","2020-11-11","2021-03-24","2020-12-02","2020-12-02","2020-12-02","2020-12-02","2020-12-02","2020-12-02","2020-12-02","2020-12-17","2020-12-14","2020-12-14","2020-12-14","2020-12-15","2020-12-15","2020-12-15","2021-03-24","2021-03-24","2021-03-24","2021-03-25","2021-03-25","2021-09-20","2022-01-11","2022-01-13","2022-01-13","2022-01-13","2022-01-13","2022-01-13","2022-01-13","2019-03-13"],"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":[["","53489011905","DOXYCYCL","CAP 100MG","28","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","30","Select","Select",""],["","57664050658","METOPROL","TAB 25MG","180","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","25.5","Select","Select",""],["","13668013501","ESCITALOPRAM","TAB 5MG","90","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","56","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":""}]}]}