{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PRESTON I SIMMS","gend":0,"add":"1903 VENABLE ST # D  ","city":"RICHMOND ","state":"VA","zip":"23223-9998","dob":"1946-03-14","age":"","mstatus":"","insh":11002271,"cliId":"2NF2RD8RX91","pno":8044399887,"cno":8044399887,"email":"","ename":"","eno":"","pphy":"GREEN, HAROLD T","ppno":8046441665,"pcpadd":"2421 Chamberlayne Ave","pcpcity":"Richmond ","pcpstate":"VA","pcpzip":232224205,"pcpcounty":"","pcpid":"P0149971","pcpname":"PRIMARY HEALTHCARE ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1903 VENABLE ST # D  ","madd2":"","madd3":"","mcity":"RICHMOND ","mstate":"VA","mzip":"23223-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["H40.1132","H25.13","B20","R63.4","R76.8","E78.5","R44.1","Z79.899","H81.10","N39.0","B97.89","W19.XXXA","I51.7","S09.90XA","I48.19","E55.9","I10","Z79.02","Z87.891","R00.1","R44.3","I48.91","Z79.01","F29","H40.9","H40.89","Z87.2","E11.9","R42","M17.0","Z68.22","F17.210","Z68.23","H26.9","R44.0","M47.816","I34.0","E78.00","K08.109","K64.9","Z21","Z68.21","Z97.2","R01.1","I35.0","I48.0","M25.531","M79.641","L08.89","M11.231","R00.0","M13.131","Z88.0","Z91.81","M85.841","R60.0","I36.1","M13.10","M11.241","Z23","Z00.00","H54.7","M54.5","M79.1","F03.90","G89.29","K59.00","R41.89","F03.91","R44.8","I45.6","R05","R07.9","R63.0","Z03.89","Z12.11","G31.84","R09.81","I48.11","Z53.09","I49.1","R63.6","Z71.89","R26.81","I35.9","M25.562","H91.90","I95.9","Z68.1"],"date":["2021-10-21","2021-10-21","2021-08-25","2020-02-19","2019-02-14","2021-09-15","2020-03-12","2021-09-15","2018-02-17","2018-08-26","2018-02-17","2018-02-17","2019-06-21","2018-02-17","2020-05-18","2021-09-15","2021-09-15","2020-02-17","2021-09-15","2021-04-06","2020-09-09","2021-08-25","2021-04-14","2019-02-25","2021-08-25","2018-03-06","2020-03-06","2018-10-25","2021-01-06","2020-03-12","2018-03-07","2020-03-12","2020-03-12","2020-03-12","2020-03-12","2020-03-12","2019-06-21","2021-05-28","2020-03-12","2018-04-25","2019-12-27","2018-04-25","2020-03-12","2018-05-31","2018-05-31","2021-03-04","2019-06-20","2019-06-20","2019-06-20","2019-07-01","2019-06-20","2019-06-20","2019-12-27","2019-06-20","2019-06-20","2019-06-20","2019-06-21","2019-06-22","2019-07-01","2021-09-15","2018-07-18","2020-08-12","2018-08-23","2018-08-23","2020-03-12","2018-08-26","2018-08-26","2018-08-30","2018-08-28","2018-08-30","2020-09-09","2020-09-09","2020-09-09","2020-09-09","2019-09-30","2018-10-25","2018-11-01","2018-11-21","2019-11-27","2019-11-27","2019-12-27","2021-05-28","2021-08-25","2020-03-12","2020-03-12","2021-08-25","2021-08-25","2021-05-28","2021-05-28"],"priorHcc":[null,null,"","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"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":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","61958250101","BIKTARVY","TAB ","","Select","Select",""],["","65862006299","METOPROL TAR","TAB 25MG","","Select","Select",""],["","70069023101","BRIMONIDINE","SOL 0.2% OP","","Select","Select",""],["","3089421","ELIQUIS","TAB 5MG","","Select","Select",""],["","16714087502","ATORVASTATIN","TAB 20MG","","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","","Select","Select",""],["","59762033302","LATANOPROST","SOL 0.00005","","Select","Select",""],["","54327099","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","69238110002","DOXYCYCL HYC","CAP 100MG","","Select","Select",""],["","54472825","PREDNISONE","TAB 5MG","","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","","Select","Select",""],["","16714085201","METOPROL SUC","TAB 25MG ER","","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","","Select","Select",""],["","3089421","ELIQUIS ","TAB 5MG","60","Select","Select",""],["","16714087502","ATORVASTATIN ","TAB 20MG","30","Select","Select",""],["","65862006299","METOPROL ","TAB 25MG","60","Select","Select",""],["","70069023101","BRIMONIDINE ","SOL 0.2% OP","5","Select","Select",""],["","61958250101","BIKTARVY ","TAB ","30","Select","Select",""],["","68180072003","AMLODIPINE ","TAB 5MG","30","Select","Select",""],["","54327099","FLUTICASONE ","SPR 50MCG","16","Select","Select",""],["","59762033302","LATANOPROST ","SOL 0.00005","2.5","Select","Select",""],["","63304069205","CLINDAMYCIN ","CAP 150MG","42","Select","Select",""],["","67877032005","IBUPROFEN ","TAB 600MG","14","Select","Select",""],["","54472825","PREDNISONE ","TAB 5MG","28","Select","Select",""],["","69238110002","DOXYCYCL ","CAP 100MG","38","Select","Select",""],["","65862006299","METOPROL","25MG","60","Select","Select",""],["","69238110002","DOXYCYCL","100MG","38","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}