{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RAQUAIL SMITH","gend":0,"add":"7804 LANCASHIRE PL","city":"RICHMOND","state":"VA","zip":"23235-9998","dob":"2003-01-15","age":"","mstatus":"","insh":"20035261*01","cliId":"","pno":"804\/299-8722","cno":"804\/267-9752","email":"","ename":"","eno":"","pphy":"BOONE, CAROLYN J MD","ppno":"804\/783-8788","pcpadd":"SUITE 101 110 N ROBINSON STREET","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23220,"pcpcounty":"","pcpid":"","pcpname":"CAROLYN J BOONE MD FAAP","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"866\/777-6407","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z00.121","E23.0","E23.7","F32.9","Z23.","D89.9","Z68.51","N50.89","E27.40","Z68.52","R73.09","Z63.9","Z60.3","Z55.9","Z59.9","Z65.8","R45.89","F34.1","F41.1","F90.0","L02.818","J30.9","J30.1","J45.40","J45.901","L20.89","H10.45","J06.9","Z03.89","R99.","F90.1","R19.00","R63.0","R62.51","E03.9","Z71.82","Z71.3","R60.9","L08.9","Z68.21","R41.840","J45.30"],"date":["2019-07-01","2021-12-01","2019-07-01","2019-07-01","2019-07-01","2019-07-01","2019-07-01","2019-10-22","2021-03-24","2020-04-30","2021-03-24","2021-09-16","2020-08-25","2021-09-16","2021-09-16","2021-09-16","2020-08-25","2021-09-16","2021-09-16","2021-04-22","2019-10-08","2021-08-16","2021-08-16","2021-08-16","2021-07-15","2021-08-16","2021-08-16","2021-07-15","2021-09-16","2021-09-16","2021-09-16","2019-07-15","2019-07-15","2019-07-15","2019-07-15","2019-07-15","2019-07-15","2019-07-15","2020-02-07","2021-12-01","2021-02-25","2021-07-14"],"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":[["","","GENOTROPIN"," GENOTROPIN ","3","Select","Select",""],["","","MONTELUKAST"," MONTELUKAST ","30","Select","Select",""],["","","NORDITROPIN"," NORDITROPIN ","3","Select","Select",""],["","","FLOVENT"," FLOVENT ","12","Select","Select",""],["","","PROAIR"," PROAIR ","17","Select","Select",""],["","","ADDERALL"," ADDERALL ","30","Select","Select",""],["","","NOVOFINE"," NOVOFINE ","100","Select","Select",""],["","","HYDROCORT"," HYDROCORT ","105","Select","Select",""],["","","GLUCAGON"," GLUCAGON ","2","Select","Select",""],["","","CEPHALEXIN"," CEPHALEXIN ","40","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","20","Select","Select",""],["","","DESONIDE"," DESONIDE ","118","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","CETIRIZINE"," CETIRIZINE ","30","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","360","Select","Select",""],["","","CORTEF","TAB 5MG","","Select","Select",""],["","","BD  PEN NEEDL","MIS 32GX4MM","","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":""}]}]}