{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TOCARRA RIGGINS","gend":1,"add":"2306   DUNEDIN  DRIVE                                       ","city":"PETERSBURG                    ","state":"VA","zip":"23803-5476","dob":"1993-05-12","age":"","mstatus":"","insh":6617715,"cliId":"","pno":8046056990,"cno":8044811359,"email":"","ename":"","eno":"","pphy":"LEWIS, JOHN W                                               ","ppno":8045205580,"pcpadd":"436 CLAIRMONT COURT,SUITE 100","pcpcity":"COLONIAL HEIGHTS              ","pcpstate":"VA","pcpzip":238340000,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"APT 1                                                       ","add3":"","madd1":"2306 DUNEDIN DRIVE","madd2":"APT 1","madd3":"","mcity":"PETERSBURG                    ","mstate":"VA","mzip":"23803-5476","pcpfaxno":5409621282,"pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E66.01","Z68.41","L02.411","X58.XXXA","Y92.009","S20.212A","Z88.0","R07.9","S51.012A","M79.89","S69.91XA","W01.0XXA","W10.9XXA","Y92.038","Y99.8","S62.622A","Z91.013","S62.624A","S51.011A","S63.432A","S62.600A","O00.00","O20.9","E87.6","Z3A.00","R10.30","N93.9","R53.1","O03.9","M27.2","L03.211","R51","S00.83XA","N73.0","T19.2XXA","F39","F41.1","F41.9","F12.10","F43.10"],"date":["2019-11-21","2019-11-21","2020-01-02","2020-01-02","2020-01-30","2020-01-02","2020-01-30","2020-01-02","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-02-04","2020-07-20","2020-07-20","2020-07-20","2020-07-20","2020-07-20","2020-07-20","2020-07-20","2020-07-23","2020-08-18","2020-08-18","2020-08-18","2020-08-18","2020-12-10","2020-12-10","2021-12-13","2021-12-08","2021-12-08","2021-12-13","2021-12-13"],"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":[["","64380080707","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","68180035103","SERTRALINE","TAB 25MG","30","Select","Select",""],["","33342006807","OLANZAPINE","TAB 5MG","30.00","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","70700011985","ESTARYLLA","TAB 0.25-35","28","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","00555901658","SPRINTEC","TAB 28 DAY","28","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","12","Select","Select",""],["","49884072703","DOXYCYC","CAP 100MG","7","Select","Select",""],["","68462018905","NAPROXEN","TAB 375MG","14","Select","Select",""],["","68382031910","TRAMADOL","TAB 50MG","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":""}]}]}