{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAMMY   K JENKINS","gend":1,"add":"4217 AMORA AVENUE","city":"HENRICO                       ","state":"VA","zip":"23228-3601","dob":"1969-02-16","age":"","mstatus":"","insh":5276503,"cliId":"","pno":8042679706,"cno":"","email":"","ename":"","eno":"","pphy":"READ, STEPHEN GEORGE","ppno":8042667611,"pcpadd":"10571 Telegraph Rd Ste 210,","pcpcity":"Glen Allen                    ","pcpstate":"VA","pcpzip":230594653,"pcpcounty":"","pcpid":"","pcpname":"BROOK RUN FAMILY PHYSICIANS","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"CENTRAL","aligned":"","ano":"","add2":"4217 AMORA AVENUE","add3":"","madd1":"4217 AMORA AVENUE","madd2":"","madd3":"","mcity":"HENRICO                       ","mstate":"VA","mzip":"23228-3601","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S16.1XXA","F07.81","G44.329","H53.9","M54.5","M25.561","I10","E66.01","M25.511","S83.8X2A","V87.7XXA","M17.12","F41.9","S16.1XXD","V87.7XXD","S40.011D","S40.011A","R53.83","S06.0X0A","G44.311","G43.709","Z68.38","F33.1","F41.0","Z68.37","E53.8","E66.9","Z68.39","S16.1XXS","F43.23","M25.562","E55.9","E78.00","G89.29","R79.89","Z13.1","M17.0","F32.5","E78.2","E66.09","Z01.812","Z11.59","G47.30","M19.90","K21.9","G89.18","E78.5","Z68.41","I95.1","Z47.1","F32.9","Z96.652","Z79.01","M79.662","R73.9","Z72.821","Z76.89","M25.662","G47.33","R63.4","M17.11","R63.5","Z12.31","Z23","M70.52","M25.862","R94.31","R26.2","M25.462","M25.469","F11.20","F43.9","L91.0","R20.3","I50.30","I35.1","I51.7","R06.00","R94.39","I25.10","R78.5","I25.118","E87.6","Z95.5","L29.9","M79.601","R20.0","G43.909","Z79.899","R07.9","I11.9","I25.83","Z68.42","E66.1","D50.8","F32.4"],"date":["2020-01-14","2020-06-18","2021-07-20","2020-01-08","2020-06-18","2020-09-08","2021-12-21","2021-11-22","2020-06-18","2020-01-14","2020-01-08","2021-07-12","2021-12-16","2020-01-14","2020-01-14","2020-01-14","2020-01-14","2021-04-19","2020-01-24","2020-01-24","2021-07-20","2020-01-24","2021-11-17","2021-11-17","2020-11-18","2021-12-27","2021-05-06","2020-04-07","2020-03-09","2020-06-01","2021-12-21","2021-12-21","2021-11-22","2021-12-21","2020-07-29","2021-05-06","2021-03-23","2020-10-21","2020-09-23","2021-04-19","2020-05-23","2020-05-23","2021-05-11","2021-05-11","2021-12-09","2020-05-27","2021-12-27","2021-12-21","2020-05-27","2020-09-04","2020-06-01","2021-08-23","2020-06-01","2021-08-23","2021-12-27","2020-10-21","2020-06-18","2021-02-15","2021-12-21","2020-07-29","2021-08-23","2021-12-27","2021-11-12","2021-11-22","2020-12-01","2021-02-15","2021-01-07","2021-02-15","2021-01-27","2021-01-28","2021-02-11","2021-11-17","2021-02-23","2021-02-23","2021-03-25","2021-03-25","2021-03-25","2021-04-19","2021-04-19","2021-12-09","2021-04-19","2021-07-07","2021-11-22","2021-07-07","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-10-27","2021-05-27","2021-07-12","2021-09-14","2021-12-21","2021-12-27","2021-12-21"],"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":[["","69097096507","NABUMETONE","TAB 500MG","60","Select","Select",""],["","65862048901","QUETIAPINE","TAB 25MG","30","Select","Select",""],["","16729020301","BUSPIRONE","TAB 15MG","90","Select","Select",""],["","69097012303","TOPIRAMATE","TAB 50MG","180","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","70377000812","ROSUVASTATIN","TAB 20MG","30","Select","Select",""],["","49884093547","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","69097083512","SERTRALINE","TAB 100MG","60","Select","Select",""],["","68382065005","ISOSORB","TAB 30MG ER","30","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","24208055555","BACIT\/POLYMY","OIN OP","3.5","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4,000.00","Select","Select",""],["","00228212750","CLONIDINE","TAB 0.1MG","180","Select","Select",""],["","69680011225","CYANOCOBALAM","INJ 1000MCG","3","Select","Select",""],["","00093083205","CLONAZEPAM","TAB 0.5MG","15","Select","Select",""],["","31604001274","FOLIC","TAB 400MCG","30","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX4MM","100","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00169280015","SAXENDA","INJ 18MG\/3ML","15","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","43598043611","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","69097081312","GABAPENTIN","CAP 100MG","14","Select","Select",""],["","60505294509","EZETIMIBE","TAB 10MG","90","Select","Select",""],["","59651017301","DOXEPIN","CAP 10MG","30","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0.3","Select","Select",""],["","00186077660","BRILINTA","TAB 60MG","120","Select","Select",""],["","08290305270","3ML","MIS 25GX1\"","3","Select","Select",""],["","08290305177","HYPO  NEEDLE  M","MIS 21GX1\"","4","Select","Select",""],["","08290305155","BD  HYPO NEED","MIS 22GX1\"","4","Select","Select",""],["","67877056110","METFORMIN","TAB 500MG","60","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","76385011350","CARVEDILOL","TAB 25MG","180","Select","Select",""],["","65862035790","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","23155000810","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","00378518693","PRASUGREL","MG TABLET","90","Select","Select",""],["","00406012401","HYDROCO\/APAP","TAB 7.5-325","40","Select","Select",""],["","50111043401","TRAZODONE","TAB 100MG","60","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","30","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","60505025203","TIZANIDINE","TAB 4MG","28","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","10","Select","Select",""],["","43547030403","ARIPIPRAZOLE","TAB 10MG","30","Select","Select",""],["","70377003012","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","50458058030","XARELTO","TAB 10MG","12","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","60","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":""}]}]}