{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"YUDELKIS LOPEZ-BARRNES","gend":1,"add":"25 GREENWOOD ROAD","city":"NEWPORT NEWS                  ","state":"VA","zip":"23601-2442","dob":"1987-12-11","age":"","mstatus":"","insh":6851976,"cliId":"","pno":"7579478194","cno":7579478194,"email":"","ename":"","eno":"","pphy":"ASPILI, CONCEPCION","ppno":7573808709,"pcpadd":"15425 Warwick Blvd Ste A,","pcpcity":"Newport News                  ","pcpstate":"VA","pcpzip":236081579,"pcpcounty":"","pcpid":"","pcpname":"PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"TIDEWATER","aligned":"","ano":"","add2":"25 GREENWOOD ROAD","add3":"","madd1":"25 GREENWOOD ROAD","madd2":"","madd3":"","mcity":"NEWPORT NEWS                  ","mstate":"VA","mzip":"23601-2442","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25.572","M79.672","N76.0","B37.3","N89.8","B96.89","Z20.2","F17.210","S92.534A","S99.921A","W10.9XXA","Z87.891","R50.9","Z20.828","R06.02","R05","F31.9","H10.9","R09.81","L03.113","M79.631","M79.89","L53.9","L29.2","Z20.822","N93.8","N93.9","R10.2","Z86.59","M54.12","M25.511","M54.2","G43.909","S09.90XA","Y04.0XXA","Y92.89","M62.838","Z32.02","T39.8X5A","G44.309","J06.9","J02.8","U07.1","J02.9","F17.290","M79.18","Z71.89","R07.9","Z79.899","Z79.84","Z79.1","Z79.52","I26.93","E66.9","I26.99","J90","R10.9","K82.8","N32.89","J98.11","Z86.16","R53.83","R11.0","Z86.711","Z79.01","Z53.21","I47.1","R07.89","F15.929","K21.9","K80.20","E80.7","K80.21","E44.0","F33.2","F12.90","U09.9","I49.8","R79.89","N39.0","R10.13","K80.70"],"date":["2020-01-04","2020-01-04","2021-09-29","2021-01-02","2021-03-16","2021-09-29","2020-06-14","2021-11-03","2020-06-30","2020-06-30","2020-06-30","2021-04-06","2021-09-07","2020-07-19","2021-09-18","2021-09-07","2020-07-19","2020-07-19","2020-07-19","2020-12-23","2020-12-23","2020-12-23","2020-12-23","2021-01-02","2021-09-07","2021-03-07","2021-03-07","2021-03-07","2021-03-16","2021-04-07","2021-04-05","2021-04-06","2021-11-03","2021-04-06","2021-04-06","2021-04-06","2021-04-06","2021-04-06","2021-04-06","2021-04-07","2021-09-07","2021-09-07","2021-09-27","2021-09-07","2021-09-18","2021-09-18","2021-09-18","2021-11-05","2021-09-27","2021-09-18","2021-11-03","2021-11-03","2021-09-19","2021-09-19","2021-11-06","2021-09-19","2021-09-19","2021-09-19","2021-09-19","2021-09-19","2021-09-19","2021-09-27","2021-09-27","2021-11-03","2021-11-03","2021-11-02","2021-11-06","2021-11-04","2021-11-03","2021-11-03","2021-11-06","2021-11-03","2021-11-06","2021-11-04","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-06","2021-11-03","2021-11-03","2021-11-04"],"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":[["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","49884072703","DOXYCYC","CAP 100MG","14","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00363091530","OMEPRAZOLE","TAB 20MG","28","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","42799011101","ETODOLAC","TAB 400MG","20","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","10","Select","Select",""],["","00591544210","PREDNISONE","TAB 10MG","20","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","27808003602","HYDROCO\/APAP","TAB 7.5-325","5","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","20","Select","Select",""],["","00045083837","TYLENOL","TAB 650MG","30","Select","Select",""],["","57664050658","METOPROL","TAB 25MG","30","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","10","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","13","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","27","Select","Select",""],["","62559049001","DIPHEN\/ATROP","TAB 2.5MG","30","Select","Select",""],["","00363033601","ACETAMINOPHEN","8H R 650MG","90","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":""}]}]}