{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ABEER   N NEAL","gend":1,"add":"1300 ST JOHN STREET","city":"RICHMOND","state":"VA","zip":"23220-2534","dob":"1983-11-24","age":"","mstatus":"","insh":6448915,"cliId":"","pno":8048783670,"cno":8048783670,"email":"","ename":"","eno":"","pphy":"SPARROW JR, CHARLES K","ppno":8047951144,"pcpadd":"2660 New Market Rd, ","pcpcity":"Henrico","pcpstate":"VA","pcpzip":232317408,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":8048778698,"add2":"APT C","add3":"","madd1":"1300 ST JOHN STREET","madd2":"APT C","madd3":"","mcity":"RICHMOND","mstate":"VA","mzip":"23220-2534","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","F41.9","F90.0","F31.89","F11.21","F39","F33.1","R52","V43.92XA","F31.81","Z20.828","I11.0","I50.9","J98.01","J18.9","J81.1","R93.89","F19.10","R94.31","F13.232","F11.23","R41.0","F06.1","F13.20","G93.40","F32.9","F19.131","F11.13","G40.909","D72.829","F13.239","R29.2","R25.1","N39.0","I10","R00.0","I49.9","F11.288","F11.10","N76.0","B96.89","R03.0","Z20.2","R68.89","R30.0","N89.8","F17.210","A41.9","J96.01","R65.20","F17.200","F31.9","Z85.028","Z88.6","Z88.1","R06.02","I16.0","E86.0","R26.89","W19.XXXA","Z79.51","F11.11","F32.2","Z13.220","Z68.37","E66.9","F41.1","Z00.01","Z04.9","R73.9","Z51.81","R73.03","G40.209","F41.8","R56.9","R55","Z86.59","Z79.899","M54.2","M54.9","V89.2XXA","N85.9","M95.3","R10.9","V43.63XA","Y92.410","I44.0","J98.4","R06.00","F17.290","J45.909","Z90.3","Z88.8","I51.7","I50.30","I34.0","Z68.38","F13.10","B37.3","R41.82","R50.9","F19.90","Z72.0","B37.9","R31.9","R60.0","F19.129","Z13.89","Z63.4","R05","R82.90","Z86.69","Z86.79","Z85.831","R51","Z76.0","Z87.891","R91.8","M79.673","A59.9","K08.89","K04.7","R35.0","R10.2","M54.5","R53.1","N77.1","F41.0","Z09","F33.9","I16.1","R44.3","Z91.5","F13.24","R45.850","F12.20","R29.6","Z20.822","W18.30XA"],"date":["2021-03-24","2021-03-22","2019-04-30","2019-10-28","2021-03-30","2020-12-17","2020-09-25","2020-02-26","2020-02-26","2020-08-02","2020-11-15","2020-07-23","2020-07-23","2020-07-23","2020-07-27","2020-07-25","2020-07-25","2021-03-25","2020-11-15","2021-03-22","2020-11-18","2020-11-18","2020-11-18","2021-03-30","2021-03-24","2020-11-18","2020-11-18","2020-11-19","2020-11-18","2021-03-22","2021-03-22","2020-11-18","2020-11-18","2021-03-22","2021-04-26","2021-01-25","2021-03-21","2019-01-18","2019-05-29","2021-01-25","2020-08-06","2019-12-18","2019-12-18","2019-12-19","2020-05-12","2020-08-06","2021-04-26","2020-07-23","2020-07-23","2020-07-23","2020-07-23","2021-03-22","2020-07-24","2020-07-23","2020-07-23","2020-07-28","2020-11-15","2020-11-16","2020-11-17","2021-03-24","2020-11-15","2020-12-22","2020-12-22","2020-12-22","2020-12-22","2020-12-22","2021-04-26","2020-12-22","2021-01-11","2021-03-22","2021-01-25","2021-04-26","2019-02-05","2019-02-05","2021-03-22","2019-02-15","2020-05-12","2020-11-15","2020-02-26","2020-02-26","2020-02-26","2020-02-26","2020-02-26","2020-02-26","2020-02-26","2020-02-26","2020-07-23","2020-07-23","2020-07-27","2021-03-22","2021-03-22","2020-07-24","2020-07-24","2020-07-26","2020-07-26","2020-07-26","2020-09-21","2020-12-17","2021-01-25","2021-03-25","2021-03-22","2021-03-22","2021-03-22","2019-04-04","2019-04-12","2019-09-12","2019-11-14","2020-11-16","2020-08-20","2021-03-22","2021-03-24","2021-03-24","2021-03-24","2021-03-24","2020-03-19","2020-07-28","2020-08-06","2021-03-22","2019-09-12","2019-10-12","2019-10-12","2019-10-12","2020-08-06","2020-08-06","2020-08-06","2020-11-15","2019-04-04","2020-06-18","2020-07-24","2020-10-08","2021-03-22","2020-11-15","2020-11-15","2021-03-22","2021-03-22","2021-03-22","2021-03-22","2021-03-22","2021-03-22"],"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":[["","12496120803","SUBOXONE ","MIS 8-2MG","42","Select","Select",""],["","69547035302","NARCAN ","SPR ","2","Select","Select",""],["","68180072003","AMLODIPINE ","TAB 5MG","30","Select","Select",""],["","27241005203","ARIPIPRAZOLE ","TAB 5MG","27","Select","Select",""],["","00228203150","ALPRAZOLAM ","TAB 1MG","90","Select","Select",""],["","57237000511","FLUCONAZOLE ","TAB 150MG","2","Select","Select",""],["","00781707787","METRONIDAZOL ","GEL 0.75%VAG","70","Select","Select",""],["","00093506201","HYDROXYZ ","TAB 50MG","120","Select","Select",""],["","68645056354","IBUPROFEN ","TAB 800MG","90","Select","Select",""],["","00093314705","CEPHALEXIN ","CAP 500MG","10","Select","Select",""],["","50111043302","TRAZODONE ","TAB 50MG","30","Select","Select",""],["","57237004805","DIVALPROEX ","TAB 500MG DR","60","Select","Select",""],["","29300013601","CLONIDINE ","TAB 0.2MG","60","Select","Select",""],["","43598044774","NICOTINE ","DIS 14MG\/24H","14","Select","Select",""],["","68382009810","PAROXETINE ","TAB 20MG","30","Select","Select",""],["","65862042005","SMZ\/TMP ","TAB 800-160","6","Select","Select",""],["","66993001968","ALBUTEROL ","AER HFA","18","Select","Select",""],["","13107000334","MIRTAZAPINE ","TAB 30MG","30","Select","Select",""],["","57237004105","PENICILLN ","TAB 500MG","28","Select","Select",""],["","16729018201","HYDROCHLOROT ","TAB 12.5MG","30","Select","Select",""],["","65862001105","SERTRALINE ","TAB 25MG","35","Select","Select",""],["","11917008502","PAIN ","TAB 500MG","20","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","",""],["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":""}]}]}