{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAIONDRIA WEST","gend":1,"add":"PO BOX 371","city":"COLONIAL BEACH                ","state":"VA","zip":"22443-0371","dob":"1993-12-08","age":"","mstatus":"","insh":4349639,"cliId":"","pno":5404988016,"cno":8047618577,"email":"","ename":"","eno":"","pphy":"DEDWYLDER, ROSIER D","ppno":5406449505,"pcpadd":"5254 Potomac Dr,Ste C","pcpcity":"King George                   ","pcpstate":"VA","pcpzip":224855832,"pcpcounty":"","pcpid":"","pcpname":"MARY WASHINGTON MEDICAL GROUP","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"PO BOX 371","add3":"","madd1":"PO BOX 371","madd2":"","madd3":"","mcity":"COLONIAL BEACH                ","mstate":"VA","mzip":"22443-0371","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["B37.0","L22","D50.9","D64.9","R53.83","I10","Z23","Z00.121","R14.3","R68.12","Z91.011","Z83.79","Z01.419","L02.91","L08.9","Z30.42","H31.013","H43.392","R87.611","Z11.59","Z01.818","J39.9","J11.1","R11.2","R19.7","R05","R87.613","Z30.09","N87.1","E78.00","D57.3","H65.191","H92.01","R50.9","Z11.52","E53.8","D51.9","D52.9","R87.612","N91.1","Z30.9","Z00.129","Z13.0","Z13.88","Z28.3","R10.2","N92.1","R06.02","R05.9","R07.89","R07.9","J80","R09.02","R06.89","U07.1","Z87.891","J20.9","Z20.822","R09.81","R07.0","R53.81","O35.9XX9","O36.8190","O26.90","O62.3","Z34.83","Z37.0","O99.02","Z3A.39","O99.824","Z78.9","Z39.2","Z71.89","Z00.110"],"date":["2020-04-08","2020-04-08","2021-08-03","2021-07-07","2022-02-14","2021-08-03","2021-06-30","2020-04-28","2020-04-28","2020-04-28","2020-04-28","2020-04-28","2020-05-28","2020-07-09","2020-07-09","2021-08-18","2020-08-06","2020-08-06","2020-08-10","2020-09-24","2020-08-20","2020-08-24","2020-08-24","2020-08-24","2020-08-24","2021-02-02","2020-09-28","2020-09-24","2021-02-25","2020-09-28","2020-09-28","2021-02-02","2021-02-02","2021-02-02","2021-02-02","2021-07-07","2021-07-07","2021-07-07","2021-08-12","2021-02-25","2021-03-26","2021-06-30","2021-05-11","2021-05-11","2021-05-11","2021-07-29","2021-07-29","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2022-02-14","2021-10-11","2021-10-11","2022-02-14","2022-02-14","2022-02-14","2022-02-14","2022-02-14","2020-03-18","2020-03-18","2020-03-27","2020-03-27","2020-03-27","2020-03-27","2020-03-27","2020-03-27","2020-03-27","2020-03-27","2020-03-29","2020-03-31","2020-03-31"],"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":[["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","15","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6.00","Select","Select",""],["","60432053716","NYSTATIN","SUS 100000","140","Select","Select",""],["","59762453802","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","80777027315","MODERNA","INJ COVID-19","0.5","Select","Select",""],["","50228043605","NAPROXEN","TAB 500MG","60","Select","Select",""],["","65862077685","MILI","TAB 0.25\/35","28","Select","Select",""],["","00052433001","NEXPLANON","IMP 68MG","1","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","60","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","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":""}]}]}