{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOSHUA   B JONES","gend":0,"add":"565 BEAL STREET                                             ","city":"HIGHLAND SPRINGS              ","state":"VA","zip":"23075-1736","dob":"1997-10-02","age":"","mstatus":"","insh":6623689,"cliId":"","pno":8042921530,"cno":"","email":"","ename":"","eno":"","pphy":"ASHRAFI, ABBAS                                              ","ppno":8046522200,"pcpadd":"4630 S Laburnum Ave Ste D                                   ,                                                            ","pcpcity":"Henrico                       ","pcpstate":"VA","pcpzip":232312441,"pcpcounty":"","pcpid":"","pcpname":"LABURNUM MEDICAL CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"565 BEAL STREET                                             ","add3":"","madd1":"565 BEAL STREET                                             ","madd2":"                                                            ","madd3":"","mcity":"HIGHLAND SPRINGS              ","mstate":"VA","mzip":"23075-1736","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S81.802A","Z48.01","E63.8","S42.351D","Z18.11","Z09","Z43.2","Z48.815","Z93.3","S42.301D","M79.601","W34.00XD","M79.641","R20.8","R53.1","L90.5","R60.9","S52.511D","S62.302D","S64.21XD","S64.01XD","Z73.6","Z91.81","S42.301A","W34.00XA","M79.603","S42.351A","S32.059D","S32.009A","Z18.89","Z98.890","S44.11XD","S44.21XD","E46","Z93.1","Z90.49","Z90.5","S42.391D","S52.301D","M25.641","M25.631","R68.89","R60.0","Z72.89","Z74.09","T14.8XXA","Z43.4","Z87.828","S62.600D","M25.621","Z93.9","Z11.59","G56.31","G56.21","M62.81","S41.131D","S31.649D","Z18.10","Z93.2","W34.00XS","Z20.828","T84.318A","Y83.8","G47.00","D64.9","Z86.718","Z87.891","Z79.1","Z47.2","S62.001D","S62.312D","G56.11","Z01.812","Z20.822","Z04.9","S44.91XA","G89.18","R10.9","S31.109A","K66.0","N17.9","F17.210","Z83.3","M25.541","R20.0","J20.9","R06.02","R06.2","R09.89","F17.200","J45.909","Z79.52","Z71.6","R09.81","R91.8","J45.21","F17.290","N45.1","N50.811"],"date":["2021-01-17","2021-02-01","2021-01-17","2021-06-07","2020-12-30","2021-06-07","2020-12-15","2021-07-30","2021-07-02","2021-10-07","2021-04-14","2021-10-07","2021-04-14","2021-04-14","2021-10-07","2021-03-01","2021-03-01","2021-04-14","2021-03-01","2020-12-10","2020-12-10","2021-03-01","2020-12-10","2020-12-15","2021-06-23","2020-12-15","2020-12-15","2020-12-24","2020-12-24","2020-12-24","2020-12-28","2020-12-30","2020-12-30","2021-01-04","2021-01-04","2021-07-13","2021-07-13","2021-01-04","2021-01-04","2021-10-07","2021-04-14","2021-10-07","2021-02-01","2021-10-07","2021-10-07","2021-01-13","2021-07-13","2021-01-22","2021-03-01","2021-02-01","2021-05-18","2021-03-01","2021-06-01","2021-03-01","2021-03-01","2021-03-01","2021-03-05","2021-03-05","2021-03-05","2021-07-13","2021-03-09","2021-03-11","2021-03-11","2021-07-13","2021-03-11","2021-03-11","2021-03-11","2021-03-11","2021-03-11","2021-04-14","2021-04-14","2021-06-01","2021-05-03","2022-03-02","2021-06-07","2021-06-23","2021-07-16","2021-07-16","2021-07-13","2021-07-13","2021-07-13","2022-07-16","2021-07-13","2021-10-07","2021-10-07","2022-03-02","2022-03-02","2022-07-10","2022-03-02","2022-03-02","2022-07-16","2022-03-02","2022-03-02","2022-03-02","2022-03-02","2022-07-10","2022-07-10","2022-08-02","2022-07-16"],"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":[["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","00603533815","PREDNISONE","PAK 10MG","21","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","6.7","Select","Select",""],["","24658031205","DOXYCYCL","TAB 100MG","14","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","8","Select","Select",""],["","65162068090","PROMETHAZINE","SOL DM","118","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","65862052305","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","07610017840","VITAMIN","TAB 5000UNIT","30","Select","Select",""],["","50111043301","TRAZODONE","TAB 50MG","15","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4,000.00","Select","Select",""],["","59746011306","PROCHLORPER","TAB 5MG","30","Select","Select",""],["","69584061250","METHOCARBAM","TAB 750MG","42","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","42","Select","Select",""],["","50428264783","STOOL","CAP 100MG","10","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","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":""}]}]}