{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TIFFANY BECK","gend":1,"add":"W 210 C BAKER ST APT A","city":"RICHMOND","state":"VA","zip":"23220-9998","dob":"1985-11-17","age":"","mstatus":"","insh":"1553215*01","cliId":"","pno":"804\/239-8596","cno":"","email":"","ename":"","eno":"","pphy":"MOSKOWITZ, HOLLY NP","ppno":"804\/828-4409","pcpadd":"401 N 11TH STREET","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23219,"pcpcounty":"","pcpid":"","pcpname":"MCV ASSOCIATED PHYSICIANS","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/828-6084","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K21.9","M54.5","G47.00","R63.4","K59.00","R11.0","F41.9","R10.10","Z87.440","O09.521","V23.2","O20.0","O99.321","F12.120","Z3A.01","F43.22","L72.0","Z88.5","R31.29","Z87.442","Z34.90","V23.87","Z01.419","NO DATA","Z87.59","H47.091","H52.13","H52.223","Z04.9","V23.41","Z33.1","R10.9","R31.9","Z01.411","R03.0","N92.0","F41.1","Z11.51","Z12.4","R68.82","Z30.09","Z30.49","R10.30","R31.0","R82.998","Z79.899"],"date":["2019-05-08","2019-04-10","2019-05-08","2019-07-01","2019-07-01","2019-07-01","2021-10-11","2020-06-04","2020-06-04","2021-08-15","2021-08-15","2021-08-19","2021-08-15","2021-08-15","2021-08-15","2020-11-12","2020-12-17","2020-10-14","2020-08-20","2020-08-20","2021-08-19","2021-08-19","2021-10-11","2021-10-11","2021-10-11","2020-10-29","2020-10-29","2020-10-29","2021-07-22","2021-07-22","2021-07-22","2020-07-22","2020-07-22","2020-09-29","2021-03-15","2020-09-29","2020-09-29","2020-09-29","2020-09-29","2021-03-15","2021-03-15","2021-03-15","2019-06-20","2019-06-20","2019-06-20","2019-06-20"],"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":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","","ESCITALOPRAM","TAB 10MG","","Select","Select",""],["","00378727253","NORETHINDRON","TAB 0.35MG","84","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","","AERCHMBR","MIS SM MASK","","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","","ALAVERT","TAB 10MG","","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","","IBUPROFEN","TAB 600MG","","Select","Select",""],["","42192033901","HYOSCYAMINE","SUB 0.125MG","100","Select","Select",""],["","00456120130","LINZESS","CAP 145MCG","30","Select","Select",""],["","65162063709","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","65862059801","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","11822003360","RA","TAB 100MCG","30","Select","Select",""],["","00527058601","DICYCLOMINE","CAP 10MG","120","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":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"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":""}]}]}