{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAVARIS TURNER","gend":0,"add":"8716 W BROAD ST","city":"HENRICO","state":"VA","zip":"23294-9998","dob":"2004-09-16","age":"","mstatus":"","insh":"20042476*01","cliId":"","pno":"540\/323-8429","cno":"","email":"","ename":"","eno":"","pphy":"DUHART, HAROLD BOBBY MD","ppno":"804\/957-9601","pcpadd":"25 SOUTH UNION STREET","pcpcity":"PETERSBURG","pcpstate":"VA","pcpzip":23803,"pcpcounty":"","pcpid":"","pcpname":"CENTRAL VIRGINIA HEALTH SERVICES INC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/947-5850","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F12.129","F12.120","F90.2","F12.20","F43.25","F42.8","F43.10","F41.1","F39.","F91.3","F43.20","F90.9","Z00.121","Z11.3","Z62.21","R61.","J45.40","G47.9","F32.9","Z00.129","Z71.89","Z71.3","Z11.1","R07.89","Z63.9","Z60.3","Z55.9","Z65.3","Z65.8","F41.8","J45.909","H01.021","H53.8","H52.13","L74.510","F90.1","Z87.892","J45.30","Z76.89","J45.20","Z91.013","F41.9","E55.9","R09.81","R46.89","F31.60"],"date":["2021-12-02","2021-11-04","2021-12-08","2021-12-31","2019-07-16","2019-07-19","2021-10-15","2019-11-25","2021-04-29","2021-10-15","2019-03-06","2019-12-18","2019-12-18","2019-12-18","2019-12-18","2020-12-23","2019-12-18","2020-12-23","2019-12-18","2021-09-08","2021-02-10","2021-02-10","2021-02-10","2020-07-18","2020-06-15","2020-06-15","2020-06-15","2020-06-15","2020-06-15","2021-03-04","2021-09-08","2021-05-28","2021-05-28","2021-05-28","2019-05-01","2020-12-23","2020-12-23","2020-12-23","2020-12-23","2019-12-03","2019-12-03","2019-12-03","2019-12-03","2019-12-03","2019-12-10","2021-11-10"],"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":[["","","MULTI-VITAMN"," MULTI-VITAMN ","31","Select","Select",""],["","","KAPVAY"," KAPVAY ","31","Select","Select",""],["","","METADATE"," METADATE ","30","Select","Select",""],["","","METHYLPHENID"," METHYLPHENID ","30","Select","Select",""],["","","MELATONIN"," MELATONIN ","31","Select","Select",""],["","","VITAMIN"," VITAMIN ","31","Select","Select",""],["","","QUETIAPINE"," QUETIAPINE ","20","Select","Select",""],["","","GUANFACINE"," GUANFACINE ","20","Select","Select",""],["","","HYPERCARE"," HYPERCARE ","60","Select","Select",""],["","","CLONIDINE"," CLONIDINE ","31","Select","Select",""],["","","EPINEPHRINE"," EPINEPHRINE ","2","Select","Select",""],["","","OXYBUTYNIN"," OXYBUTYNIN ","34","Select","Select",""],["","","CONCERTA"," CONCERTA ","30","Select","Select",""],["","","DIVALPROEX"," DIVALPROEX ","30","Select","Select",""],["","","BUSPIRONE"," BUSPIRONE ","60","Select","Select",""],["","","QBREXZA"," QBREXZA ","30","Select","Select",""],["","","SERTRALINE"," SERTRALINE ","31","Select","Select",""],["","","TAB-A-VITE"," TAB-A-VITE ","31","Select","Select",""],["","","SYMBICORT"," SYMBICORT ","10","Select","Select",""],["","","PROVENTIL"," PROVENTIL ","7","Select","Select",""],["","","VENTOLIN"," VENTOLIN ","18","Select","Select",""],["","","TRAZODONE","TAB 50MG","","Select","Select",""],["","","BUDES\/FORMOT","AER 80-4.5","","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":""}]}]}