{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LAMON   O WHITE","gend":0,"add":"2124 CLARK STREET                                           ","city":"RICHMOND                      ","state":"VA","zip":"23228-5742","dob":"2003-01-24","age":"","mstatus":"","insh":1317727,"cliId":"","pno":8043007052,"cno":8049091733,"email":"","ename":"","eno":"","pphy":"CAROLYN BOONE MD                                            ","ppno":"","pcpadd":"110 N Robinson St,Ste C","pcpcity":"Richmond                      ","pcpstate":"VA","pcpzip":232204459,"pcpcounty":"","pcpid":"P0138667","pcpname":"CAROLYN J BOONE MD PC.","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"2124 CLARK STREET                                           ","madd2":"                                                            ","madd3":"","mcity":"RICHMOND                      ","mstate":"VA","mzip":"23228-5742","pcpfaxno":8667776407,"pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R10.31","R10.32","R10.9","R11.0","F90.2","F90.9","J30.1","J30.9","Z68.52","F91.3","F91.9","M79.10","M54.9","M79.601","M79.602","M79.604","M79.605","Z71.82","Z71.3","R07.81","S20.219A","R07.9","W18.30XA","Y92.009","S01.412A","W22.8XXA","Z23","J18.9","Z00.121","R05","D89.9","Z03.89","F32.9","E55.9","Z01.00","R07.89","F43.9","F17.210","J02.9"],"date":["2019-01-22","2019-01-22","2019-01-22","2019-01-22","2019-02-05","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2019-06-12","2019-09-18","2019-09-18","2019-09-18","2019-09-18","2019-09-18","2019-09-18","2020-07-30","2020-07-30","2019-12-02","2019-12-02","2020-12-21","2019-12-02","2019-12-02","2019-12-22","2019-12-22","2019-12-22","2020-01-27","2020-07-30","2020-01-27","2020-07-30","2020-01-27","2020-07-30","2020-07-30","2020-07-30","2020-12-21","2020-12-21","2020-12-21","2021-06-16"],"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":[["","00002323930","STRATTERA","60MG","30","Select","Select",""],["","69842000003","FLUTICASONE","50MCG","9.9","Select","Select",""],["","51660052601","ALLERGY","10MG","30","Select","Select",""],["","45802065078","LORATADINE","10MG","30","Select","Select",""],["","68180016013","AZITHROMYCIN","250MG","6","Select","Select",""],["","65862001501","AMOXICILLIN","875MG","20","Select","Select",""],["","31604001870","VITAMIN","1000UNIT","30","Select","Select",""],["","00002323930","STRATTERA ","CAP 60MG","30","Select","Select",""],["","69842000003","FLUTICASONE ","SPR 50MCG","9.9","Select","Select",""],["","51660052601","ALLERGY ","TAB 10MG","30","Select","Select",""],["","45802065078","LORATADINE ","TAB 10MG","30","Select","Select",""],["","68180016013","AZITHROMYCIN ","TAB 250MG","6","Select","Select",""],["","65862001501","AMOXICILLIN ","TAB 875MG","20","Select","Select",""],["","31604001870","VITAMIN ","TAB 1000UNIT","30","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":""}]}]}