{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KATHY   E DICKINSON","gend":1,"add":"901 HILLCREST AVENUE                                        ","city":"HENRICO                       ","state":"VA","zip":"23075-1145","dob":"1968-08-07","age":"","mstatus":"","insh":6061540,"cliId":"","pno":8045015703,"cno":2762392873,"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":"901 HILLCREST AVENUE                                        ","add3":"","madd1":"901 HILLCREST AVENUE                                        ","madd2":"                                                            ","madd3":"","mcity":"HENRICO                       ","mstate":"VA","mzip":"23075-1145","pcpfaxno":"(804) 780-0862","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K21.9","J44.9","G47.00","H26.9","H91.91","J32.9","R05","I25.2","R00.1","R06.02","B34.9","R06.00","R91.8","M79.642","J42","L02.01","F17.210","I10","J44.1","F17.200","A41.9","N10","Z76.5","F14.10","K83.01","F39","Z91.14","F41.9","M81.0","R74.8","N12","R50.9","R07.9","R10.9","K59.00","E87.6","K74.60","Z87.11","Z79.899","Z72.0","R74.01","R00.0","R93.3","N39.0","Z12.31","Z12.11","R79.89","R73.03","E78.5","Z13.29","E55.9","N30.00","Z11.59","F32.9","R68.89","I21.29","R94.31","J44.0","J22","F33.1","J18.9","Z88.5","Z88.6","F90.2"],"date":["2022-01-23","2020-10-22","2021-05-14","2020-03-16","2020-03-16","2020-03-16","2021-03-27","2020-06-08","2020-06-08","2022-01-23","2020-06-08","2021-03-27","2020-06-08","2020-06-19","2020-07-17","2020-07-17","2022-01-23","2022-01-23","2021-05-14","2021-01-13","2020-11-02","2020-10-22","2020-10-21","2020-10-21","2020-10-23","2020-10-21","2020-10-21","2020-10-29","2022-01-23","2020-10-23","2020-10-23","2020-10-22","2020-10-21","2020-10-22","2020-10-21","2020-10-22","2020-10-22","2022-01-23","2022-01-23","2021-03-27","2020-10-23","2020-10-23","2020-10-23","2020-11-02","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2021-02-03","2021-03-27","2021-03-27","2022-01-23","2021-05-14","2021-07-18","2022-01-23","2022-01-23","2022-01-23","2022-02-07"],"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":[["","55111028130","LEVOFLOXACIN","TAB 750MG","4","Select","Select",""],["","45802008801","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","72647033104","METHYLPRED","TAB 4MG","21","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","68180044601","QUETIAPINE","TAB 50MG","30","Select","Select",""],["","68382080601","TRAZODONE","TAB 100MG","14","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","14","Select","Select",""],["","","ESOMEPRA","CAP 40MG DR","30","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59746017310","PREDNISONE","TAB 10MG","30","Select","Select",""],["","69452014430","BENZONATATE","CAP 200MG","30","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","60","Select","Select",""],["","00536118297","MUCUS&CHST","LIQ 100\/5ML","118","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","10","Select","Select",""],["","31722094101","HYDROCO\/APAP","TAB 5-325MG","6","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}