{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PATRICIA   A PARKER","gend":1,"add":"123 N KALMIA AVENUE","city":"HENRICO                       ","state":"VA","zip":"23075-1809","dob":"1989-05-26","age":"","mstatus":"","insh":5696030,"cliId":"","pno":8046171134,"cno":"","email":"","ename":"","eno":"","pphy":"CLARK, RALPH R","ppno":8048289357,"pcpadd":"417 N 11th St,","pcpcity":"Richmond                      ","pcpstate":"VA","pcpzip":232985002,"pcpcounty":"","pcpid":"","pcpname":"MCV AMBULATORY CARE CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"123 N KALMIA AVENUE","add3":"","madd1":"123 N KALMIA AVENUE","madd2":"","madd3":"","mcity":"HENRICO                       ","mstate":"VA","mzip":"23075-1809","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F53.0","F43.21","J11.89","Z87.891","Z01.419","Z11.3","N93.8","E66.01","Z68.43","Z30.46","L73.2","Z68.44","Z72.51","E66.9","Z71.3","Z01.818","Z11.59","K30","R10.13","F54","F12.21","F33.0","D64.9","B20","L08.0","L83","L90.5","Z01.812","Z20.822","K44.9","Z79.899","Z79.3","Z82.49","R07.9","R11.2","E86.0","R51.9","Z98.84","R42","K76.89","K59.00","Z68.42","Z11.52","K29.70","R13.10","Z68.41"],"date":["2020-03-03","2020-03-03","2020-02-23","2021-06-22","2020-06-29","2021-02-26","2020-06-29","2021-09-13","2021-06-28","2020-06-29","2021-10-08","2020-10-23","2020-08-14","2021-12-27","2021-09-13","2020-12-26","2020-12-26","2020-12-29","2020-12-29","2021-01-13","2021-01-13","2021-01-13","2021-02-26","2021-02-26","2021-04-09","2021-05-21","2021-04-09","2021-05-25","2021-06-22","2021-09-15","2021-06-17","2021-06-17","2021-06-17","2021-06-18","2021-06-22","2021-09-17","2021-06-22","2021-12-27","2021-06-22","2021-06-23","2021-06-28","2021-09-13","2021-09-13","2021-12-27","2021-09-15","2021-12-27"],"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":[["","80777027398","MODERNA","INJ COVID-19","0.5","Select","Select",""],["","75834002001","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","59779060462","IBUPROFEN","TAB 200MG","84","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","28","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","90","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","50428041228","SKIN","SOL 0.04","473","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","16","Select","Select",""],["","00904699880","DOCUSATE","CAP 100MG","28","Select","Select",""],["","49483034010","ACETAMIN","TAB 325MG","84","Select","Select",""],["","49483008010","SENNA-TIME","TAB 8.6MG","14","Select","Select",""],["","69238131109","PREGABALIN","CAP 50MG","18","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","45802005611","GENTAMICIN","CRE 0.001","30","Select","Select",""],["","47781030801","NITROFUR","CAP 100MG","10","Select","Select",""],["","00555901658","SPRINTEC","TAB 28 DAY","84","Select","Select",""],["","00234057508","HIBICLENS","LIQ 0.04","236","Select","Select",""],["","68462047301","URSODIOL","TAB 250MG","60","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","90","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","30","Select","Select",""],["","68180067711","OSELTAMIVIR","CAP 75MG","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":""}]}]}