{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JABARI   A RANDOLPH","gend":0,"add":"8211 BOWERS LN","city":"RICHMOND","state":"VA","zip":"23227-9998","dob":"1976-06-10","age":"","mstatus":"","insh":"900037683*01","cliId":"","pno":"804\/264-5574","cno":"","email":"","ename":"","eno":"","pphy":"HUNGATE, LINDA BETH NP","ppno":"804\/828-4624","pcpadd":"1300 E MARSHAL ST","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23298,"pcpcounty":"","pcpid":"","pcpname":"MCV ASSOCIATED PHYSICIANS","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/828-3983","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R04.2","R09.89","J96.10","G82.51","S14.104S","L89.313","N31.9","I10.","D64.9","I25.2","Z99.81","J18.9","J96.00","Z99.11","Z93.0","G82.52","G82.50","J96.90","J44.1","L89.312","E03.9","L89.219","E11.9","J96.20","G90.4","E55.9","Z87.440","Z96.0","D72.829","R14.0","R60.0","R74.8","N20.0","I49.9","J44.9","Z79.82","Z79.51","Z86.718","Z99.3","Z48.89","G82.20","D84.9","R33.9","J96.01","N39.0","J98.4","R06.00","R91.8","J98.19","T17.590A","L89.323","J96.21","L89.513","L89.224","I47.2","J98.11","Z43.0","J81.1","I51.7","J90.","R82.71","M62.838","J96.91","N13.2","F32.9","R32.","L22.","R39.81","B37.49","Z87.442","Z87.2","L89.319","Z98.890","M61.551","M16.0","M43.28","M76.891","M76.892","L89.209","K59.00","R25.2","F32.A","L89.159","Z23.","J98.09","Z01.818","B37.89","Z11.59","K59.2","N32.89","R82.90","E11.37X9","E11.622","L89.309","N28.1","L89.310","J96.11","R19.07","D69.6","N13.30","E87.5","I49.3","Z71.9","Z92.29","Z87.891","Z01.812","N20.2","Z87.01","R03.0","R17.","M24.573","M24.576","M24.549","M62.81","N28.89","Q63.1","R94.31","J15.0","Z74.01","Q25.46","K56.7","R00.1","Y84.4","L89.153","Z79.2","E87.6","I45.9"],"date":["2021-11-23","2020-12-11","2021-09-07","2021-12-05","2020-09-10","2021-12-11","2021-12-05","2021-11-22","2021-11-04","2020-09-10","2020-11-06","2021-08-17","2021-09-02","2021-12-05","2021-11-22","2021-11-22","2021-09-02","2021-11-04","2020-03-26","2021-05-07","2021-11-04","2021-09-07","2021-11-22","2020-11-06","2021-11-22","2021-11-04","2021-12-05","2021-07-06","2020-11-06","2020-11-06","2020-11-03","2020-11-06","2021-02-18","2021-04-15","2020-12-08","2021-11-22","2020-12-08","2020-12-23","2020-12-08","2020-12-09","2021-06-27","2021-12-05","2021-12-05","2021-06-30","2021-07-02","2021-06-30","2021-06-27","2021-11-09","2021-11-09","2021-06-27","2021-06-27","2021-07-02","2021-06-27","2021-06-27","2021-06-27","2021-11-23","2021-12-11","2021-11-23","2021-07-01","2021-07-01","2021-07-01","2021-09-07","2021-07-03","2020-10-06","2021-09-07","2020-11-02","2020-11-02","2020-11-02","2020-12-11","2021-03-16","2020-12-11","2021-08-13","2021-07-01","2021-05-28","2021-05-28","2021-05-28","2021-05-28","2021-05-28","2021-07-06","2021-11-04","2021-11-04","2021-11-04","2021-10-22","2021-10-22","2021-11-09","2020-12-04","2020-12-21","2020-12-21","2021-03-16","2021-09-20","2021-10-25","2021-11-04","2021-11-04","2021-11-04","2020-09-12","2020-06-08","2021-11-22","2020-11-02","2020-11-02","2020-11-04","2021-09-07","2021-06-29","2020-01-08","2020-01-08","2020-03-05","2020-12-21","2020-12-23","2020-07-23","2020-09-04","2020-11-03","2021-04-29","2021-01-11","2021-04-29","2021-04-29","2021-02-18","2021-02-18","2021-06-27","2021-06-30","2021-07-03","2021-11-23","2020-11-03","2021-10-28","2021-11-22","2021-11-22","2021-11-22","2020-11-04","2021-04-16"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"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":[]},{"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":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","68180016006","AZITHROMYCIN                                                          ","250MG","45","Select","Select",""],["","69452015120","VITAMIN D                                                             ","50000UNT","4","Select","Select",""],["","65862086001","FAMOTIDINE                                                            ","40MG","90","Select","Select",""],["","45802046564","KETOCONAZOLE                                                          ","2%","120","Select","Select",""],["","00378967130","IPRATROPIUM BROMIDE\/ALBUTEROL SULFATE                                 ","ALBUTER","540","Select","Select",""],["","68308015230","NYSTATIN                                                              ","100000","30","Select","Select",""],["","00378181377","LEVOTHYROXINE SODIUM                                                  ","125MCG","90","Select","Select",""],["","00603497528","OXYBUTYNIN CHLORIDE                                                   ","5MG","360","Select","Select",""],["","00832105515","BACLOFEN                                                              ","20MG","180","Select","Select",""],["","00781185220","AMOXICILLIN\/CLAVULANATE POTASSIUM                                     ","875-125","14","Select","Select",""],["","00378699789","SODIUM CHLORIDE                                                       ","3%","750","Select","Select",""],["","00487950125","ALBUTEROL SULFATE                                                     ","0.08%","150","Select","Select",""],["","00799000104","CALMOSEPTINE                                                          ","","113","Select","Select",""],["","47781057701","METHENAMINE HIPPURATE                                                 ","1GM","180","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE\/TRIMETHOPRIM DS                                      ","800-160","20","Select","Select",""],["","51293081101","PHENAZOPYRIDINE HCL                                                   ","200MG","9","Select","Select",""],["","62756016013","TAMSULOSIN HYDROCHLORIDE                                              ","0.4MG","30","Select","Select",""],["","70710113803","FLUCONAZOLE                                                           ","100MG","7","Select","Select",""],["","00406055201","OXYCODONE HYDROCHLORIDE                                               ","5MG","7","Select","Select",""],["","70000044701","SENNA REGULAR STRENGTH                                                ","8.6MG","3","Select","Select",""],["","60846050201","PYRIDIUM                                                              ","200MG","9","Select","Select",""],["","00536106210","STOOL SOFTENER                                                        ","100MG","6","Select","Select",""],["","00536100901","FERROUS SULFATE                                                       ","325MG","90","Select","Select",""]]}},{"a":[]},{"a":[]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"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":"","a13":""}]}]}