{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WILLIAM   A JOHNSON IV","gend":0,"add":"144 VIRGINIA AVENUE                                         ","city":"PETERSBURG                    ","state":"VA","zip":"23803-5876","dob":"1991-09-18","age":"","mstatus":"","insh":10036108,"cliId":"","pno":8047336306,"cno":8047336306,"email":"","ename":"","eno":"","pphy":"DUHART, HAROLD BOBBY                                        ","ppno":"","pcpadd":"541 S Sycamore St,2116 W Laburnum Ave Ste 100","pcpcity":"Petersburg                    ","pcpstate":"VA","pcpzip":238035039,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"CENTRAL","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"144 VIRGINIA AVENUE                                         ","madd2":"                                                            ","madd3":"","mcity":"PETERSBURG                    ","mstate":"VA","mzip":"23803-5876","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S92.411A","S92.511A","S91.311A","W20.8XXA","S99.921A","Y93.H2","Y99.8","K04.7","R22.0","M27.2","K02.9","R69","T14.90XA","S20.219A","R07.81","V63.6XXA","Y92.410","S30.1XXA"],"date":["2019-12-05","2019-12-05","2019-12-05","2019-12-05","2019-12-05","2019-12-05","2019-12-05","2020-02-26","2020-02-26","2020-02-26","2020-02-26","2020-09-02","2020-09-02","2020-09-02","2020-09-02","2020-09-02","2020-09-02","2020-09-02"],"priorHcc":["","","","","","","","","","","","","","","","","",""]}},{"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":[]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","57237002801","AMOXICILLIN","500MG","21","Select","Select",""],["","64380080707","IBUPROFEN","800MG","20","Select","Select",""],["","65862018601","CLINDAMYCIN","300MG","30","Select","Select",""],["","00406012305","HYDROCO\/APAP","5-325MG","6","Select","Select",""],["","00116200116","CHLORHEX","0.12%","473","Select","Select",""],["","57237002801","AMOXICILLIN ","TAB 500MG","21","Select","Select",""],["","64380080707","IBUPROFEN ","TAB 800MG","20","Select","Select",""],["","65862018601","CLINDAMYCIN ","CAP 300MG","30","Select","Select",""],["","00406012305","HYDROCO\/APAP ","TAB 5-325MG","6","Select","Select",""],["","00116200116","CHLORHEX ","SOL 0.0012","473","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":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","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":""}]}]}