{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RAMON   G BRIGHT","gend":0,"add":"1600   OAK PLACE BOULEVARD                                  ","city":"RICHMOND                      ","state":"VA","zip":"23231-4866","dob":"2003-02-13","age":"","mstatus":"","insh":10048197,"cliId":"","pno":8046877868,"cno":8046877868,"email":"","ename":"","eno":"","pphy":"BUSH, JAMES A","ppno":"","pcpadd":"815 W POYTHRESS ST","pcpcity":"HOPEWELL                      ","pcpstate":"VA","pcpzip":238602532,"pcpcounty":"","pcpid":"P0118404","pcpname":"HOPEWELL MEDICAL CENTER","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"CENTRAL","aligned":"","ano":"","add2":"APT 202                                                     ","add3":"","madd1":"1600   OAK PLACE BOULEVARD                                  ","madd2":"APT 202                                                     ","madd3":"","mcity":"RICHMOND                      ","mstate":"VA","mzip":"23231-4866","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J45.30","Z71.89","Z71.3","Z23","L84","J02.9","M62.838","M75.22","M75.82","R07.89","R07.9","R06.02","M25.512","F12.929","F41.1","M79.602","M54.6","R41.0","T14.8XXA","F12.921","S29.012A","X50.1XXA","G90.512","F90.9","F41.9","F32.9","J45.909","Z82.49","Z11.59","G89.0","Z91.19","R55","R06.89","I49.9","I51.7","R41.82","F12.90","Z63.4","R45.4","R42","R53.1","G47.9","G93.89","M54.2","R20.2","F44.5","F43.0","R45.851","F43.9","F48.9","W26.0XXA","S50.811A","F91.3","Z77.22","Z91.5","R00.1","R94.31","R00.0","Z86.79","F81.9","F39","F31.30","R10.2","M25.571"],"date":["2019-02-08","2020-01-14","2020-01-14","2019-10-07","2019-10-07","2020-01-14","2020-08-15","2020-08-15","2020-08-15","2020-12-01","2021-01-25","2020-11-24","2020-08-24","2020-08-20","2020-08-20","2020-08-24","2020-08-20","2020-08-20","2020-08-20","2020-08-20","2020-08-20","2020-08-20","2020-08-24","2020-10-27","2020-08-23","2021-01-27","2020-10-27","2020-08-23","2020-08-21","2020-08-24","2020-08-21","2021-01-26","2020-08-21","2020-08-22","2020-08-21","2020-08-24","2020-08-21","2020-08-21","2020-08-21","2020-11-24","2020-08-23","2020-08-23","2020-08-23","2020-08-24","2020-08-24","2020-08-24","2020-10-16","2021-01-25","2020-10-16","2020-10-27","2020-10-16","2020-10-16","2020-10-27","2020-10-27","2020-10-27","2020-12-03","2020-11-26","2020-12-03","2020-12-03","2021-01-26","2021-01-26","2021-02-09","2021-03-06","2021-04-26"],"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":[["","65862001705","AMOXICILLIN","500MG","20","Select","Select",""],["","00904674759","IBUPROFEN","200MG","120","Select","Select",""],["","00904671960","ACETAMINOPHE","325MG","120","Select","Select",""],["","51991001406","MELATONIN","3MG","30","Select","Select",""],["","51672129801","KETOCONAZOLE","2%","15","Select","Select",""],["","65862001705","AMOXICILLIN ","CAP 500MG","20","Select","Select",""],["","00904674759","IBUPROFEN ","TAB 200MG","120","Select","Select",""],["","00904671960","ACETAMINOPHE ","TAB 325MG","120","Select","Select",""],["","51991001406","MELATONIN ","TAB 3MG","30","Select","Select",""],["","51672129801","KETOCONAZOLE ","CRE 0.02","15","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","",""],["Yes","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":""}]}]}