{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIERRA   J ROYER","gend":1,"add":"2108   JOPLIN AVENUE                                        ","city":"RICHMOND                      ","state":"VA","zip":"23224-9998","dob":"1998-11-27","age":"","mstatus":"","insh":10229594,"cliId":"","pno":8045286582,"cno":8045286582,"email":"","ename":"","eno":"","pphy":"KHAN, SHUJA U                                               ","ppno":"","pcpadd":"5 W Nine Mile Rd,Ste 103","pcpcity":"Henrico                       ","pcpstate":"VA","pcpzip":230751345,"pcpcounty":"","pcpid":"P0060157","pcpname":"HIGHLAND SPRINGS PRIMARY CARE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"2108   JOPLIN AVENUE                                        ","madd2":"                                                            ","madd3":"","mcity":"RICHMOND                      ","mstate":"VA","mzip":"23224-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O36.80X0","Z3A.11","O34.42","O23.592","R87.612","Z3A.15","N76.0","Z36.0","Z34.90","Z01.419","Z34.92","Z3A.27","O26.892","R10.9","Z3A.00","O26.893","R06.4","R10.13","Z3A.28","O9A.213","S89.92XA","W51.XXXA","O35.2XX0","Z3A.37","O42.02","O66.5","Z37.0","Z3A.38","O42.92","Z34.03","O76","O69.1XX0","O14.04","E87.6","O90.89","O70.1","O80","Z39.0","F33.8","F99","F43.0","R45.851","Z63.0","Z79.899","R68.89","T74.31XA"],"date":["2020-02-13","2020-02-13","2020-03-04","2020-03-04","2020-03-04","2020-03-04","2020-03-04","2020-08-04","2020-05-05","2020-03-04","2020-05-27","2020-05-27","2020-06-04","2020-06-04","2020-08-15","2020-06-04","2020-06-04","2020-06-04","2020-06-04","2020-06-04","2020-06-04","2020-06-04","2020-08-04","2020-08-04","2020-08-15","2020-08-15","2020-08-15","2020-08-15","2020-08-15","2020-08-15","2020-08-15","2020-08-15","2020-08-15","2020-08-15","2020-08-15","2020-08-15","2020-08-15","2020-08-17","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-11-25"],"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":[["","49483060350","IBUPROFEN","600MG","40","Select","Select",""],["","59762453701","MEDROXYPR","150MG\/ML","1","Select","Select",""],["","68180016013","AZITHROMYCIN","250MG","6","Select","Select",""],["","10006073030","FERROUS","325MG","60","Select","Select",""],["","57896070310","IRON","325MG","60","Select","Select",""],["","55111014512","FLUCONAZOLE","150MG","1","Select","Select",""],["","50111033402","METRONIDAZOL","500MG","14","Select","Select",""],["","00904531360","PRENATAL","27-0.8MG","30","Select","Select",""],["","00093220301","METOCLOPRAM","10MG","120","Select","Select",""],["","49483060350","IBUPROFEN ","TAB 600MG","40","Select","Select",""],["","59762453701","MEDROXYPR ","INJ 150MG\/ML","1","Select","Select",""],["","68180016013","AZITHROMYCIN ","TAB 250MG","6","Select","Select",""],["","10006073030","FERROUS ","TAB 325MG","60","Select","Select",""],["","57896070310","IRON ","TAB 325MG","60","Select","Select",""],["","55111014512","FLUCONAZOLE ","TAB 150MG","1","Select","Select",""],["","50111033402","METRONIDAZOL ","TAB 500MG","14","Select","Select",""],["","00904531360","PRENATAL ","TAB 27-0.8MG","30","Select","Select",""],["","00093220301","METOCLOPRAM ","TAB 10MG","120","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","",""],["N\/A","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":""}]}]}