{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TYANA AVANS","gend":1,"add":"1374 GREENMOSS DRIVE","city":"RICHMOND                      ","state":"VA","zip":"23225-4113","dob":"2001-10-10","age":"","mstatus":"","insh":6798402,"cliId":"","pno":8044518632,"cno":8047372626,"email":"","ename":"","eno":"","pphy":"VINIEGRA SIBAL, AMABEL C","ppno":8045240055,"pcpadd":"301 Jennick Dr Ste A,","pcpcity":"Colonial Heights              ","pcpstate":"VA","pcpzip":238344904,"pcpcounty":"","pcpid":"","pcpname":"VIRGINIA PEDIATRICS PC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"1374 GREENMOSS DRIVE","add3":"","madd1":"506 Magnolia Farms Dr","madd2":"APT B","madd3":"","mcity":"Petersburg                    ","mstate":"VA","mzip":"23803-4605","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F90.2","F43.25","F33.0","Z30.013","Z30.09","Z30.42","Z32.02","F41.9","F32.9","F43.9","M25.562","G89.29","R07.89","F17.200","I49.9","M25.462","R07.9","F43.0","R10.10","R10.84","Z32.00","K59.00","R10.9","R11.2","R10.30","R10.11","Z00.00","J02.9","O20.9","Z3A.01","O46.91","O21.9","O99.511","O99.331","Z3A.12","Z20.828","F23","O99.340","Z3A.00","F32.2","R45.851","F90.9","F33.9","H54.7","K21.9","I49.8","O26.891","O99.611","H53.121","N92.6","Z13.0","Z30.011","Z01.419","Z11.3","Z11.8","Z11.2","S00.83XA","W10.9XXA","S29.012A","M41.9","R40.2142","R40.2252","R40.2362","S09.93XA","M41.85","M41.84","N76.0","F39","Z30.017","E55.9","F98.8","F34.81","M79.674","S90.414A","W22.8XXA","S99.921A","R53.83","R53.1","R35.0","R11.0","Z20.822","K29.70","J06.9","R09.81","R49.9","R10.31","R10.32","Z3A.17","M79.89","S89.91XA","S93.401A","W19.XXXA","F31.81","F34.9","F33.2","F11.20","F90.0","R06.00","Z00.121","Z62.21","J30.1","L70.0","Z68.54","E66.9","R05","R52","R51"],"date":["2022-03-21","2020-05-28","2020-05-28","2020-02-03","2020-02-03","2020-07-16","2021-02-11","2021-08-25","2021-08-25","2020-05-20","2020-05-20","2020-05-20","2020-05-20","2021-03-17","2020-05-20","2020-05-20","2020-11-23","2020-05-20","2020-07-08","2020-07-08","2020-07-08","2020-07-12","2020-07-12","2021-07-08","2021-05-06","2020-07-12","2021-03-01","2020-09-14","2020-09-10","2020-11-23","2020-09-10","2020-09-10","2020-09-14","2020-09-14","2020-09-14","2020-09-14","2020-09-20","2020-09-20","2020-09-20","2021-10-27","2020-09-21","2021-08-25","2020-11-17","2020-11-23","2020-11-23","2020-11-23","2020-11-23","2020-11-23","2020-11-23","2021-02-09","2021-01-12","2021-01-12","2021-01-12","2021-01-19","2021-01-19","2021-01-12","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-19","2021-08-25","2021-02-11","2021-03-01","2021-03-01","2021-09-03","2021-03-17","2021-03-17","2021-03-17","2021-03-17","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-08-02","2021-07-08","2021-08-02","2021-08-02","2021-08-02","2021-08-30","2021-08-30","2021-08-30","2021-10-28","2021-10-28","2021-10-28","2021-10-28","2021-11-07","2022-01-31","2021-11-22","2022-03-14","2019-05-06","2019-03-02","2019-05-06","2019-05-06","2019-05-06","2019-05-06","2019-05-06","2019-05-06","2019-11-09","2019-11-09","2019-11-23"],"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":[["","43547030303","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","30768019941","VITAMIN","CAP 50MCG","31","Select","Select",""],["","07610022640","MELATONIN","TAB 3MG","4","Select","Select",""],["","16714075801","ATOMOXETINE","CAP 40MG","31","Select","Select",""],["","70677000101","DECONGESTANT","TAB 120MG ER","15","Select","Select",""],["","16714029904","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","21","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","00172572960","FAMOTIDINE","TAB 40MG","23","Select","Select",""],["","68180083773","TRI-LO-","TAB MARZIA","28","Select","Select",""],["","00591079501","DICYCLOMINE","TAB 20MG","15","Select","Select",""],["","00904625549","SORE","LOZ 15-3.6MG","18","Select","Select",""],["","49348081709","ACID","TAB 20MG","31","Select","Select",""],["","00904672080","ACETAMIN","TAB 500MG","30","Select","Select",""],["","43386031214","GAVILAX","POW ","510","Select","Select",""],["","16714099901","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","16714070701","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","65862019405","FLUOXETINE","CAP 40MG","29","Select","Select",""],["","00378729953","DROSPIR\/ETHI","TAB 3-0.02MG","28","Select","Select",""],["","54092038701","ADDERALL","CAP 20MG","30","Select","Select",""],["","68462072029","DROSPIRENONE","TAB ETHY EST","28","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","20","Select","Select",""],["","16714080701","AMPHET\/DEXTR","TAB 20MG","30","Select","Select",""],["","50111043303","TRAZODONE","TAB 50MG","31","Select","Select",""],["","60432053716","NYSTATIN","SUS 100000","200","Select","Select",""],["","49348001734","SM","SYP 100-10\/5","118","Select","Select",""],["","50383077504","LIDOCAINE","SOL 2% VISC","100","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":""}]}]}