{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TREVON   R FAISON","gend":0,"add":"2125 SILVERBERRY DRIVE","city":"CHESAPEAKE                    ","state":"VA","zip":"23321-3281","dob":"1998-11-28","age":"","mstatus":"","insh":6600852,"cliId":"","pno":7575351043,"cno":"","email":"","ename":"","eno":"","pphy":"WILLIAMS, MICHAEL","ppno":7579838600,"pcpadd":"114 N Main St Ste 200,","pcpcity":"Suffolk                       ","pcpstate":"VA","pcpzip":234344564,"pcpcounty":"","pcpid":"","pcpname":"SENTARA FAMILY AND INTERNAL MEDICINE PHYSICIANS","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"TIDEWATER","aligned":"","ano":"","add2":"2125 SILVERBERRY DRIVE","add3":"","madd1":"2125 SILVERBERRY DRIVE","madd2":"APT 108","madd3":"","mcity":"CHESAPEAKE                    ","mstate":"VA","mzip":"23321-3281","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J96.00","I50.20","E87.70","J18.9","E83.30","D64.9","N17.9","R04.89","S27.329A","V87.7XXA","N39.0","R50.9","R91.8","R07.9","Z74.09","Z78.9","R41.89","R26.89","S42.301A","R13.10","T07.XXXA","S06.0X9D","V47.9XXD","Z43.0","S42.351D","S02.31XD","S27.329D","N17.0","Z99.2","D63.1","R33.8","E66.01","R00.0","S27.339D","F41.9","J98.11","Z93.0","J81.1","J98.09","T82.49XA","S06.0X9A","S02.31XA","J96.10","I11.0","I42.9","I50.9","R60.9","I10","N18.32","E87.6","Z45.2","N18.6","N18.30","J80","I50.31","I50.21","T88.4XXA","S42.351A","T14.90XA","R53.1","V89.2XXD","G56.31","M24.521","M24.511","I26.09","R06.02","J96.01","Z68.43","Z20.822","R77.8","I26.99","R05","R07.1","Z88.8","R79.89","D50.0","J02.9","R06.1","J98.4","R68.89","J81.0","E66.9","I50.32","E66.3","I50.43","G47.33","I42.8","S42.301G","S06.0X0A","S02.85XD","X58.XXXD","E55.9","S61.401A","Z99.81","F32.9","J96.11","Z68.42","S01.81XA","R06.00","I51.81","I50.42","E66.2","Z86.711","I51.9","I27.20","T80.1XXA","Z79.01","S06.9X9A","V09.9XXA","Z13.220","Z13.6","Z13.1","T23.001A","L97.529","I87.312","L97.319","Z20.828","S81.809A","R73.03","S91.301A","S91.302A","S91.104A","X58.XXXA","G47.30","Z11.59","I51.7"],"date":["2021-03-01","2021-03-01","2021-03-01","2021-03-01","2021-03-01","2021-04-13","2021-05-14","2021-03-03","2021-03-03","2021-05-14","2021-03-20","2021-03-01","2021-03-15","2021-03-01","2021-03-01","2021-03-01","2021-03-01","2021-06-02","2021-03-20","2021-05-14","2021-03-03","2021-03-04","2021-03-04","2021-03-04","2021-10-08","2021-03-04","2021-03-04","2021-03-31","2021-03-20","2021-03-31","2021-03-04","2021-12-03","2021-04-13","2021-03-04","2021-03-04","2021-03-05","2021-04-13","2021-03-18","2021-03-18","2021-03-15","2021-03-20","2021-05-14","2021-03-20","2021-04-13","2021-05-14","2021-04-29","2021-03-24","2021-12-03","2021-03-24","2021-03-24","2021-04-01","2021-04-01","2021-04-12","2021-05-14","2021-10-29","2021-05-14","2021-05-14","2021-04-12","2021-05-14","2021-09-01","2021-04-12","2021-10-08","2021-10-08","2021-10-08","2021-05-17","2021-05-03","2021-04-17","2021-12-03","2021-04-13","2021-04-13","2021-05-14","2021-04-13","2021-04-13","2021-06-07","2021-04-13","2021-04-13","2021-04-13","2021-04-13","2021-04-13","2021-04-14","2021-04-17","2021-04-15","2021-12-01","2021-04-22","2021-04-23","2021-10-01","2021-12-14","2021-06-28","2021-04-26","2021-04-29","2021-10-08","2021-12-03","2021-08-23","2021-05-03","2021-05-06","2021-10-01","2021-10-01","2021-05-14","2021-10-01","2021-08-20","2021-12-14","2021-10-01","2021-10-01","2021-05-14","2021-05-14","2021-08-23","2021-09-20","2021-06-28","2021-06-28","2021-08-04","2021-08-04","2021-08-04","2021-08-05","2021-08-05","2021-08-05","2021-08-05","2021-08-09","2021-08-23","2021-12-03","2021-09-20","2021-09-20","2021-09-20","2021-09-20","2021-10-01","2021-12-03","2021-12-31"],"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":[["","00378021610","FUROSEMIDE","TAB 40MG","90","Select","Select",""],["","53746051101","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","57664016758","METOPROL","TAB 100MG","180","Select","Select",""],["","00078065920","ENTRESTO","TAB 24-26MG","60","Select","Select",""],["","00310621030","FARXIGA","TAB 10MG","30","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","63044062201","RENO","CAP ","30","Select","Select",""],["","00955105027","SEVELAMER","TAB 800MG","90","Select","Select",""],["","68180059206","DESVENLAFAX","TAB 50MG ER","90","Select","Select",""],["","67877019905","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","00245531911","KLOR-CON","TAB 20MEQ ER","90","Select","Select",""],["","31722070090","LOSARTAN","TAB 25MG","90","Select","Select",""],["","23155000201","HYDRALAZINE","TAB 25MG","180","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","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":""}]}]}