{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANGELA POWELL","gend":1,"add":"1124 HOLLISTER AVENUE","city":"RICHMOND","state":"VA","zip":"23224-5014","dob":"1982-11-09","age":"","mstatus":"","insh":6781980,"cliId":"","pno":8043099170,"cno":"","email":"","ename":"","eno":"","pphy":"VILLANUEVA, JOHN G","ppno":8044525800,"pcpadd":"8380 BOYDTON PLANK ROAD, ","pcpcity":"PRINCE GEORGE","pcpstate":"VA","pcpzip":238751400,"pcpcounty":"","pcpid":"","pcpname":"HOPEWELL PRINCE GEORGE COMMUNITY HEALTH CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"TRLR 19","add3":"","madd1":"1124 Hollister Ave","madd2":"","madd3":"","mcity":"Richmond","mstate":"VA","mzip":"23224-5014","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","F14.10","F15.10","F31.12","F90.2","F41.1","B18.2","F14.20","Z20.828","F17.200","F17.210","F41.9","R11.0","K04.7","K08.89","R22.0","F10.20","Z51.81","Z13.29","Z13.220","Z13.21","Z13.228","F31.13","F11.11","L03.114","L02.414","A41.9","E87.6","R65.20","F31.4","F33.1","F33.2","F43.10","F31.81","R50.9","L53.9","M79.632","F11.10","S00.11XA","H57.89","W22.8XXA","Y92.89","Y99.0","S00.211A","Z23"],"date":["2021-11-17","2020-07-02","2021-01-12","2021-12-21","2021-12-21","2021-12-21","2020-10-05","2020-09-22","2020-07-27","2022-03-29","2021-11-17","2021-02-22","2021-03-10","2021-03-13","2021-03-13","2021-03-13","2021-04-29","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2021-10-14","2021-10-24","2021-11-09","2022-03-14","2021-11-09","2021-11-09","2021-11-09","2021-12-23","2022-03-25","2022-01-26","2022-01-26","2022-02-23","2022-03-14","2022-03-14","2022-03-14","2022-03-29","2019-04-28","2019-04-28","2019-04-28","2019-04-28","2019-04-28","2019-04-28","2019-04-28"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","00555097402","AMPHET\/DEXTR","TAB 30MG","60","Select","Select",""],["","29300011416","LAMOTRIGINE","TAB 200MG","30","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14.00","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","15","Select","Select",""],["","00115180301","HYDROXYZ","CAP 25MG","90","Select","Select",""],["","68462022201","LITHIUM","CAP 600MG","90","Select","Select",""],["","16729020301","BUSPIRONE","TAB 15MG","60","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","40","Select","Select",""],["","64380080907","IBUPROFEN","TAB 400MG","30","Select","Select",""],["","57237007810","ONDANSETRON","TAB 8MG ODT","30","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","00904672059","ACETAMIN","TAB 500MG","20","Select","Select",""],["","51224012250","AZITHROMYCIN","TAB 500MG","3","Select","Select",""],["","00591024105","LORAZEPAM","TAB 1MG","60","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","40","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":""}]}]}