{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LARRY GODSEY","gend":0,"add":"10213 KAY VEE ROAD","city":"RICHMOND","state":"VA","zip":"23236-9998","dob":"1961-02-10","age":"","mstatus":"","insh":"20040648*01","cliId":"","pno":"804\/461-0215","cno":"","email":"","ename":"","eno":"","pphy":"WINTHROP, ELIZABETH NP","ppno":"804\/828-6163","pcpadd":"1200 E BROAD STREET","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23298,"pcpcounty":"","pcpid":"","pcpname":"MCV ASSOCIATED PHYSICIANS","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/828-2338","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F32.2","B20.","B18.2","K70.9","D69.59","E11.9","Z79.84","I10.","Z79.899","Z85.46","Z01.818","Z11.59","K76.89","K74.60","R20.2","D69.6","Z86.19","F10.10","Z86.010","D69.3","C61.","K02.9","E78.5","B19.20","Z23.","K92.1","Z87.891","M79.601","R03.0","F19.10","H02.89","H35.039","D31.31","H25.13","D12.3","K64.8","K22.8","K31.819","K31.7","K29.80","K76.9","R77.2","NO DATA","K82.8","R97.20","F10.988","F19.21"],"date":["2020-11-02","2021-07-15","2020-06-05","2020-09-03","2020-06-05","2021-03-29","2021-03-29","2021-07-15","2021-07-15","2020-06-05","2020-10-12","2020-10-12","2020-05-26","2020-10-14","2020-09-24","2020-09-24","2021-01-12","2021-01-12","2021-01-12","2020-11-13","2021-07-15","2020-06-12","2021-03-29","2021-05-12","2021-04-19","2020-10-14","2020-06-05","2020-12-16","2020-01-31","2020-01-31","2020-07-16","2020-07-16","2020-07-16","2020-07-16","2020-10-14","2020-10-14","2020-10-14","2020-10-14","2020-10-14","2020-10-14","2021-05-12","2019-06-18","2019-03-08","2019-04-26","2019-05-03","2019-03-06","2019-03-06"],"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":[["","","AMLODIPINE","TAB 10MG","","Select","Select",""],["","","BIKTARVY","TAB ","","Select","Select",""],["","","METFORMIN","TAB 500MG","","Select","Select",""],["","65862050220","AMOX\/K","TAB 500-125","21","Select","Select",""],["","","ONETOUCH","TES VERIO","","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","1","Select","Select",""],["","","ATORVASTATIN","TAB 10MG","","Select","Select",""],["","","APAP\/CODEINE","TAB 300-30MG","","Select","Select",""],["","","DICLOFENAC","TAB 50MG DR","","Select","Select",""],["","","CHLORHEX","SOL 0.0012","","Select","Select",""],["","","GAVILYTE-G","SOL ","","Select","Select",""],["","","OXYCODONE","TAB 5MG","","Select","Select",""],["","","IBUPROFEN","TAB 600MG","","Select","Select",""],["","","CVS","TAB 5MG","","Select","Select",""],["","","GENTLE","TAB 5MG EC","","Select","Select",""],["","49702023113","TRIUMEQ","TAB ","30","Select","Select",""],["","00074262528","MAVYRET","TAB 100-40MG","84","Select","Select",""],["","65162069388","ATOVAQUONE","SUS 750\/5ML","300","Select","Select",""],["","58160082311","SHINGRIX","INJ 50MCG","1","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}