{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAMIE   E SHEFFIELD","gend":1,"add":"111 MARVIN AVE COLONIAL HEIGHTS","city":"COLONIAL HEIGHTS","state":"VA","zip":"23834-9998","dob":"1987-01-17","age":"","mstatus":"","insh":"2089730*01","cliId":"","pno":"804\/481-1388","cno":"","email":"","ename":"","eno":"","pphy":"MARTIN, CAITLIN E MD","ppno":"804\/628-6777","pcpadd":"1001 E LEIGH STREET","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23298,"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\/806-7588","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S82.001A","G89.18","F31.9","F11.21","F15.20","F13.10","N92.6","F39.","I10.","F17.210","G25.81","F11.90","T14.90XA","R69.","F14.21","NO DATA","F41.9","F13.90","E66.9","Z30.8","F33.1","Z72.0","F11.10","F15.21","J45.20","Z87.891","F31.72","F41.0","F41.8","Z30.46","Z71.6","F15.90","F11.20","F33.9","F41.1","F33.42","K02.9","F17.200","Z79.899","S82.041A","Z11.51","F13.20","D31.31","Z33.1","F15.280","F32.9","Z86.79","F19.10","S62.343A","S62.345A","V43.62XA","S80.12XA","S09.90XA","B19.20","F17.211","Z86.19","Z23.","F15.10","F33.40","O10.013","O26.613","Z3A.33","O42.019","O70.1","Z3A.36","Z37.0","O42.919","K83.1","O26.62","O70.0","O99.344","O99.52","Z3A.37","Z3A.31","Z30.017","O99.325","O99.345","O16.5","O99.323","O99.333","Z3A.35","Z39.2","F13.14","O80.","Z3A.34","O10.913","O99.513","Z3A.32","V23.89","Z12.4","Z11.3"],"date":["2021-12-02","2021-12-02","2020-07-08","2021-12-21","2021-12-21","2020-07-29","2020-07-29","2020-12-23","2021-12-02","2021-12-02","2020-07-29","2021-07-26","2021-11-21","2021-11-21","2021-12-21","2021-12-22","2021-12-21","2020-11-06","2020-11-06","2020-12-23","2021-10-20","2021-10-20","2021-11-23","2020-02-05","2020-03-04","2020-01-08","2020-02-12","2020-02-12","2021-01-20","2021-06-30","2021-06-30","2021-08-25","2021-08-25","2021-04-12","2021-09-22","2021-07-28","2021-06-30","2021-08-25","2021-08-25","2021-12-02","2020-11-06","2020-12-23","2021-10-18","2020-11-06","2020-09-02","2020-09-02","2020-09-02","2020-12-02","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2020-02-05","2020-02-05","2020-12-02","2020-12-02","2021-09-22","2021-09-22","2019-03-13","2019-03-13","2019-02-20","2019-03-16","2019-03-16","2019-03-16","2019-03-16","2019-03-16","2019-03-16","2019-03-16","2019-03-16","2019-03-16","2019-03-16","2019-03-16","2019-02-04","2019-03-18","2019-06-26","2019-06-26","2019-06-26","2019-03-13","2019-03-06","2019-03-06","2019-04-17","2019-11-13","2019-03-16","2019-02-27","2019-02-13","2019-02-13","2019-02-13","2019-02-13","2019-10-18","2019-10-18"],"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":[["","","VRAYLAR","CAP 1.5MG","","Select","Select",""],["","65862000701","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","62175045832","BUPREN\/NALOX","SUB 8-2MG","3","Select","Select",""],["","65862001205","SERTRALINE","TAB 50MG","30","Select","Select",""],["","00093506110","HYDROXYZ","TAB 25MG","56","Select","Select",""],["","65162010150","GABAPENTIN","CAP 100MG","28","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","","SUBOXONE","MIS 8-2MG","","Select","Select",""],["","96295011492","NICOTINE","LOZ 2MG MINT","72","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","40","Select","Select",""],["","00378113401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","20","Select","Select",""],["","13668003760","RISPERIDONE","TAB 1MG","30","Select","Select",""],["","52817018110","CLONIDINE","TAB 0.2MG","30","Select","Select",""],["","67253090310","ALPRAZOLAM","TAB 2MG","90","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","","TERCONAZOLE","CRE 0.008","","Select","Select",""],["","","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","00781707787","METRONIDAZOL","GEL 0.75%VAG","70","Select","Select",""],["","","CLONAZEPAM","TAB 0.5MG","","Select","Select",""],["","","SM","GUM 4MG","","Select","Select",""],["","42806050301","URSODIOL","CAP 300MG","100","Select","Select",""],["","68382080001","LABETALOL","TAB 300MG","60","Select","Select",""],["","24208083060","NEO\/POLY\/DEX","SUS 0.1% OP","5","Select","Select",""],["","00049490030","ZOLOFT","TAB 50MG","30","Select","Select",""],["","12496030001","SUBLOCADE","INJ 300\/1.5","2","Select","Select",""],["","00069046956","CHANTIX","TAB 1MG","56","Select","Select",""],["","45802048678","DOCUSATE","CAP 100MG","30","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":""}]}]}