{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KWANG   J KIM","gend":1,"add":"11521 WOODLAND POND PARKWAY                                 ","city":"CHESTERFIELD                  ","state":"VA","zip":"23838-5254","dob":"1938-05-07","age":"","mstatus":"","insh":10049697,"cliId":"","pno":8043104508,"cno":8042397358,"email":"","ename":"","eno":"","pphy":"ELLIS, LISA L                                               ","ppno":"","pcpadd":"6433 Centralia Rd","pcpcity":"Chesterfield                  ","pcpstate":"VA","pcpzip":238326556,"pcpcounty":"","pcpid":"P0060382","pcpname":"INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"CENTRAL","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"11521 WOODLAND POND PARKWAY                                 ","madd2":"                                                            ","madd3":"","mcity":"CHESTERFIELD                  ","mstate":"VA","mzip":"23838-5254","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.16","G89.4","M51.37","H57.89","H02.032","H02.831","H02.834","H02.042","H04.221","H04.569","H25.11","H31.012","I10","E78.5","H26.9","H25.12","F41.9","R79.9","R73.03","C44.319","L94.2","L57.8","D22.39","D48.5","H35.61","Z96.1","Z12.11","K21.9","H44.2A1","H44.22","H35.33","M54.17","M47.817","H35.351","M51.36","R42","Z23","Z68.22"],"date":["2020-10-07","2020-10-07","2019-01-16","2019-02-25","2019-03-25","2019-02-25","2019-02-25","2019-03-25","2019-03-15","2020-06-17","2021-07-01","2020-06-17","2021-06-01","2020-06-29","2019-04-03","2019-05-08","2019-05-08","2020-06-29","2020-01-06","2020-03-31","2020-02-18","2020-02-18","2020-02-18","2020-02-18","2020-06-17","2020-06-17","2020-06-29","2020-06-29","2021-11-04","2021-11-04","2021-11-04","2020-08-28","2020-08-28","2020-09-03","2020-10-07","2020-10-22","2021-03-08","2021-06-01"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","",null,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":[]},{"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":[["","00093720198","PRAVASTATIN","20MG","90","Select","Select",""],["","68180072003","AMLODIPINE","5MG","30","Select","Select",""],["","00378632477","VALSART\/HCTZ","320-12.5","30","Select","Select",""],["","53746010901","HYDROCO\/APAP","5-325MG","14","Select","Select",""],["","00172392670","DIAZEPAM","5MG","1","Select","Select",""],["","45802057178","FEXOFENADINE","180MG","30","Select","Select",""],["","49281012165","FLUZONE","2021-22","0.7","Select","Select",""],["","60758011905","PREDNISOLONE","1% OP","5","Select","Select",""],["","70461012003","FLUAD","0.5ML","0.5","Select","Select",""],["","60505056000","OFLOXACIN","0.3% OP","5","Select","Select",""],["","00093720198","PRAVASTATIN ","TAB 20MG","90","Select","Select",""],["","68180072003","AMLODIPINE ","TAB 5MG","30","Select","Select",""],["","00378632477","VALSART\/HCTZ ","TAB 320-12.5","30","Select","Select",""],["","53746010901","HYDROCO\/APAP ","TAB 5-325MG","14","Select","Select",""],["","00172392670","DIAZEPAM ","TAB 5MG","1","Select","Select",""],["","45802057178","FEXOFENADINE ","TAB 180MG","30","Select","Select",""],["","49281012165","FLUZONE ","INJ 2021-22","0.7","Select","Select",""],["","60758011905","PREDNISOLONE ","SUS 1% OP","5","Select","Select",""],["","70461012003","FLUAD ","INJ 0.5ML","0.5","Select","Select",""],["","60505056000","OFLOXACIN ","DRO 0.3% OP","5","Select","Select",""],["","80777027398","MODERNA ","INJ COVID-19","0.25","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":""}]}]}