{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RENEE   A WITCHER","gend":1,"add":"1007 ST. JOHN STREET","city":"RICHMOND                      ","state":"VA","zip":"23220-2564","dob":"1971-02-18","age":"","mstatus":"","insh":5333057,"cliId":"","pno":8044779350,"cno":"","email":"","ename":"","eno":"","pphy":"VCU CENTER FOR ADVANCED HEALTH","ppno":"","pcpadd":"MCV Physicians,2116 W Laburnum Ave Ste 100","pcpcity":"Richmond                      ","pcpstate":"VA","pcpzip":232274359,"pcpcounty":"","pcpid":"","pcpname":"VCU CENTER FOR ADVANCED HEALTH-SL","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"CENTRAL","aligned":"","ano":"","add2":"1007 ST. JOHN STREET","add3":"","madd1":"1007 ST. JOHN STREET","madd2":"APT A","madd3":"","mcity":"RICHMOND                      ","mstate":"VA","mzip":"23220-2564","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I63.9","I10","E11.9","E78.5","R53.1","I69.354","R29.700","D50.9","J45.909","Z79.01","Z79.84","Z91.19","Z91.018","Z91.041","Z53.29","R42","R51","Z86.73","F41.1","G45.9","I42.8","I27.0","I63.511","D64.9","F41.9","R09.89","I63.031","G43.909","K21.9","F40.240","Z79.899","I27.20","G81.94","R40.2142","I65.29","I65.21","I66.9","G81.04","E11.49","L03.114","D53.9","I80.8","M79.632","R00.0","R68.89","I63.30","D50.0","J45.40","D63.1","Z79.82","Z91.81","I69.954","I69.998","R29.818","R26.89","R29.898","Z51.81","Z79.02","Z60.9","Z74.09","F34.1","Z00.00","I69.359","Z68.27","M62.838","F90.2","I69.398","M79.602","R69","R25.2","R73.03","E78.2","F32.1","Z13.31","S05.01XA","S05.02XA","H10.013","T15.11XA","S05.01XD","R03.0","R51.9","F33.0","G45.1","N76.0","B96.89","N89.8","Z20.2","I63.50","R20.0","Z53.20","U07.1"],"date":["2020-04-16","2021-09-23","2020-05-04","2020-06-16","2021-09-23","2021-05-05","2020-01-16","2020-06-16","2021-09-23","2020-05-04","2020-05-04","2020-01-16","2020-01-16","2020-01-16","2020-04-17","2020-01-16","2020-01-17","2021-06-30","2020-01-29","2020-04-11","2020-04-11","2020-04-11","2021-09-23","2020-04-12","2020-04-16","2020-04-11","2020-04-12","2020-04-12","2020-06-16","2020-04-12","2021-06-30","2020-04-12","2020-11-25","2020-04-12","2020-04-13","2020-04-13","2020-04-14","2020-04-21","2020-04-21","2020-04-17","2020-04-17","2020-04-17","2020-04-17","2020-04-17","2021-02-25","2020-04-18","2020-04-20","2020-04-20","2020-05-04","2021-06-30","2020-08-14","2020-06-08","2020-06-08","2020-08-14","2021-05-05","2021-05-05","2020-06-16","2020-06-16","2020-06-16","2020-06-16","2020-06-16","2020-06-16","2020-06-16","2020-06-16","2020-06-18","2020-10-05","2021-05-05","2020-08-14","2020-08-28","2021-01-05","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-11-29","2020-11-29","2020-11-29","2020-11-29","2020-12-02","2020-12-10","2020-12-10","2021-07-27","2021-11-03","2021-06-30","2021-06-30","2021-06-30","2021-06-30","2021-09-23","2021-09-23","2021-09-23","2021-12-17"],"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":[["","60505258009","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","30","Select","Select",""],["","67877056105","METFORMIN","TAB 500MG","60","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN 5MG\/GM","3.5","Select","Select",""],["","64980051505","OFLOXACIN","DRO 0.3% OP","5","Select","Select",""],["","00591565810","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","69842054478","ARTHRTS","TAB 650MG","100","Select","Select",""],["","67405055005","DOXYCYCL","TAB 100MG","12","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","90","Select","Select",""],["","57664050658","METOPROL","TAB 25MG","30","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","59779046768","ASPIRIN","CHW 81MG","30","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":""}]}]}