{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NAOMI   R ARTHURS","gend":1,"add":"216 MARSHALL AVENUE","city":"NEW CASTLE","state":"VA","zip":"24127-7988","dob":"1976-07-30","age":"","mstatus":"","insh":3259687,"cliId":"","pno":5407650152,"cno":5407650152,"email":"","ename":"","eno":"","pphy":"SIMPSON, MICHAEL R","ppno":7579552828,"pcpadd":"885 Kempsville Rd, Ste 320","pcpcity":"Norfolk","pcpstate":"VA","pcpzip":235023800,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"216 MARSHALL AVENUE","madd2":"                                                            ","madd3":"","mcity":"NEW CASTLE","mstate":"VA","mzip":"24127-7988","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N20.0","Z76.89","R10.31","Z87.442","Z87.19","Z12.31","R05","Z20.828","M25.50","M79.89","Z71.3","Z68.41","R53.83","J01.00","R21","R06.83","R07.0","J02.9","R60.9","G47.00","J30.9","M54.5","R03.0","G43.009","Z11.59","D72.820","B34.9","B00.1","Z00.00","R40.0","L51.9","G47.33","R73.01","D64.9","M79.631","R10.13","G72.9","M79.601","G47.19","F33.1","F51.01"],"date":["2019-01-07","2019-01-07","2019-01-07","2019-01-07","2020-05-19","2020-06-10","2020-08-08","2020-08-08","2021-02-26","2021-02-26","2021-02-26","2021-02-26","2021-02-26","2021-02-26","2021-02-26","2020-09-25","2021-03-22","2020-02-28","2020-12-11","2020-03-30","2020-03-30","2019-01-02","2020-10-05","2020-10-05","2020-09-18","2021-03-05","2019-04-21","2019-07-08","2020-05-19","2020-06-12","2020-05-19","2020-09-25","2019-05-14","2019-05-14","2019-05-14","2019-08-06","2020-05-19","2019-08-06","2020-06-15","2020-05-19","2020-05-19"],"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":[["","50111043403","TRAZODONE ","TAB 100MG","60","Select","Select",""],["","16714079904","CETIRIZINE ","TAB 10MG","30","Select","Select",""],["","51660052601","ALLERGY ","TAB 10MG","30","Select","Select",""],["","60505082901","FLUTICASONE ","SPR 50MCG","16","Select","Select",""],["","13668000705","ZOLPIDEM ","TAB 5MG","15","Select","Select",""],["","61442010210","DICLOFENAC ","TAB 50MG DR","60","Select","Select",""],["","10702002601","PHENTERMINE ","CAP 15MG","30","Select","Select",""],["","65862067605","ALPRAZOLAM ","TAB 0.25MG","60","Select","Select",""],["","67877021905","CEPHALEXIN ","CAP 500MG","20","Select","Select",""],["","67877057305","BENZONATATE ","CAP 100MG","30","Select","Select",""],["","57237004390","VALACYCLOVIR ","TAB 1GM","21","Select","Select",""],["","68180032301","ESZOPICLONE ","TAB 2MG","30","Select","Select",""],["","00115166001","PROPRANOLOL ","TAB 20MG","60","Select","Select",""],["","16729013416","ALLOPURINOL ","TAB 100MG","30","Select","Select",""],["","69097015815","MELOXICAM ","TAB 7.5MG","30","Select","Select",""],["","65162019050","NAPROXEN ","TAB 500MG","30","Select","Select",""],["","68180067711","OSELTAMIVIR ","CAP 75MG","10","Select","Select",""],["","10702025350","BUT\/APAP\/CAF ","TAB ","60","Select","Select",""],["","65862001501","AMOXICILLIN ","TAB 875MG","20","Select","Select",""],["","64380080308","RANITIDINE ","TAB 150MG","30","Select","Select",""],["","51862053516","BROM\/PSE\/DM ","SYP ","280","Select","Select",""],["","00000000000",""," ","360","Select","Select",""],["","00781165510","PENICILLN ","TAB 500MG","20","Select","Select",""],["","33342002607","FAMCICLOVIR ","TAB 500MG","6","Select","Select",""],["","00093227534","AMOX\/K ","TAB 875-125","20","Select","Select",""],["","00143973910","PREDNISONE ","TAB 10MG","21","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":""}]}]}