{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TYREEK   R BARNES","gend":0,"add":"TYREEK BARNES","city":"RICHMOND","state":"VA","zip":"23224-1538","dob":"2000-07-30","age":"","mstatus":"","insh":6710598,"cliId":"","pno":8048829795,"cno":8048829795,"email":"","ename":"","eno":"","pphy":"BROOKS-WILLIAMS, MALINDA","ppno":8047800840,"pcpadd":"4730 N Southside Plaza St, ","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232241742,"pcpcounty":"","pcpid":"","pcpname":"SOUTH SIDE MEDICAL CENTER","ano":8046467000,"add2":"4024 OLD MIDLOTHIAN TURNPIKE APT 203","add3":"","madd1":"TYREEK BARNES","madd2":"4024 OLD MIDLOTHIAN TURNPIKE APT 203","madd3":"","mcity":"RICHMOND","mstate":"VA","mzip":"23224-1538","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F90.2","F31.0","F70","E87.6","E11.9","F31.9","F33.1","J06.9","R05","J02.9","Z20.828","Z79.84","F10.20","F12.10","F43.10","R21","L70.9","F19.959","F90.9","Z72.0","Z02.89","F31.81","Z11.7","R68.89","F41.9","R06.02","K21.9","R03.0","R53.81","R53.83","E03.9","Z79.899","Z79.1","R40.4","F20.0","F23","Z11.1","F29","Z00.00","R00.2","F17.200"],"date":["2021-02-26","2020-12-28","2020-08-10","2019-04-19","2021-01-26","2020-08-19","2021-03-07","2020-11-06","2020-12-02","2020-11-06","2020-12-02","2021-01-26","2020-12-22","2020-12-22","2020-12-22","2019-02-13","2019-02-13","2019-04-18","2019-04-18","2019-04-18","2019-04-25","2019-04-28","2019-10-14","2021-01-26","2021-01-26","2021-01-26","2021-01-26","2021-01-26","2021-01-26","2021-01-26","2021-01-26","2021-01-26","2021-01-26","2019-04-18","2019-04-20","2019-04-18","2020-11-02","2019-04-18","2020-06-11","2021-01-26","2020-12-02"],"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":[["","51672413204","LAMOTRIGINE ","TAB 150MG","60","Select","Select",""],["","29300014901","QUETIAPINE ","TAB 100MG","30","Select","Select",""],["","29300013601","CLONIDINE ","TAB 0.2MG","30","Select","Select",""],["","00228306011","AMPHET\/DEXTR ","CAP 20MG ER","30","Select","Select",""],["","45802065087","LORATADINE ","TAB 10MG","30","Select","Select",""],["","60505082901","FLUTICASONE ","SPR 50MCG","16","Select","Select",""],["","51224022060","METFORMIN ","TAB 1000MG","30","Select","Select",""],["","23155050101","HYDROXYZ ","TAB 25MG","20","Select","Select",""],["","54092038701","ADDERALL ","CAP 20MG","30","Select","Select",""],["","11822332470","RA ","SUS ANTI-GAS","355","Select","Select",""],["","65862021150","MINOCYCLINE ","CAP 100MG","60","Select","Select",""],["","13107003134","MIRTAZAPINE ","TAB 15MG","15","Select","Select",""],["","50111043302","TRAZODONE ","TAB 50MG","30","Select","Select",""],["","65862085901","FAMOTIDINE ","TAB 20MG","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":[[["Yes","Select","","","","","Select","",""],["Yes","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":""}]}]}