{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TIFFANY VAUGHT-GIVENS","gend":1,"add":"1003 EDGE HILL ROAD","city":"RICHMOND","state":"VA","zip":"23220-1204","dob":"1979-01-14","age":"","mstatus":"","insh":5584724,"cliId":"","pno":8045496172,"cno":"","email":"","ename":"","eno":"","pphy":"REYNOLDS-CANE, DIANNE LENA","ppno":8047800840,"pcpadd":"2809 North Ave Ste 206, ","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232223647,"pcpcounty":"","pcpid":"","pcpname":"GREATER FULTON MEDICAL CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"1003 EDGE HILL ROAD","madd2":"","madd3":"","mcity":"RICHMOND","mstate":"VA","mzip":"23220-1204","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z30.42","G43.909","E53.8","R10.13","E55.9","M15.9","I10","Z92.29","R68.89","R79.89","R79.9","M54.5","Z79.899","Z12.31","K76.9","Z85.05","Z79.1","Z85.72","R10.11","R74.8","Z11.59","R94.5","K21.9","K80.70","Z68.25","R89.9","R06.02","I11.9","R94.31","H93.299","Z01.812","Z20.822","R19.8","Z68.24","K71.9","K75.9","R17","R82.998","K80.51","K85.90","C85.90","F12.90","Z98.51","Z85.71","Y84.8","K83.8","K80.20","R74.01","R10.9","K72.00","Z87.19","D73.4","K80.50","R93.2","R00.1","Z98.890","Z68.23","K74.01","Z23","K80.42","C81.90","K80.12","K85.10","K91.5","Z01.419","Z32.02"],"date":["2022-02-08","2021-09-15","2021-06-18","2021-02-23","2021-06-18","2021-09-17","2021-09-17","2021-09-17","2021-06-18","2021-09-17","2021-06-18","2021-06-18","2021-09-17","2021-02-04","2021-02-23","2021-02-23","2021-02-23","2021-06-05","2021-02-23","2021-07-12","2021-03-22","2021-07-12","2021-09-15","2021-06-24","2021-09-17","2021-09-17","2021-06-18","2021-04-22","2021-04-22","2021-04-22","2021-09-13","2021-09-13","2021-05-19","2021-06-03","2021-06-03","2021-06-03","2021-06-09","2021-06-03","2021-06-06","2021-09-15","2021-09-15","2021-06-04","2021-06-04","2021-06-04","2021-06-04","2021-06-07","2021-09-15","2021-06-04","2021-09-17","2021-06-07","2021-06-05","2021-06-05","2021-06-10","2021-06-07","2021-06-07","2021-06-10","2021-06-18","2021-07-12","2021-07-12","2021-09-15","2021-09-02","2021-09-15","2021-09-15","2021-09-17","2021-09-21","2021-11-23"],"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":[["","65862056090","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","1","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","30","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","62175011843","OMEPRAZOLE","CAP 20MG","60","Select","Select",""],["","62756052269","SUMATRIPTAN","TAB 100MG","9","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","12","Select","Select",""],["","00904672080","ACETAMIN","TAB 500MG","60","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","21","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","69238110305","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","20","Select","Select",""],["","70954005930","PREDNISONE","PAK 10MG","21","Select","Select",""],["","59762453802","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","10","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":""}]}]}