{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ALYSSA   N STATON","gend":1,"add":"2511 PLEASANT RUN DR APT F","city":"HENRICO","state":"VA","zip":"23238-9998","dob":"1991-04-04","age":"","mstatus":"","insh":"5527112*01","cliId":"","pno":"804\/318-6313","cno":"","email":"","ename":"","eno":"","pphy":"JACKSON, JORDAN MD","ppno":"804\/741-6200","pcpadd":"9600 PATTERSON AVE","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23229,"pcpcounty":"","pcpid":"","pcpname":"PATTERSON AVENUE FAMILY PRACTICE","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/741-6213","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E55.9","R79.89","R53.82","F17.210","F33.41","R07.9","M62.838","E78.2","R73.01","R68.89","Z68.41","N91.4","Z32.02","F33.2","F41.1","F32.1","H66.90","E66.01","R53.83","Z12.4","Z13.220","Z76.89","F41.8","M25.561","M76.51","M25.531","H60.92","F17.200","H92.02","N91.2","F41.9","E11.9","F41.0","Z20.828","K76.0","E11.8","Z01.411","H60.502","R03.0","Z23.","F41.3","F33.9","R00.0","R07.89"],"date":["2020-07-21","2020-10-28","2020-07-21","2020-07-21","2020-10-28","2020-07-21","2020-07-21","2020-07-21","2020-07-21","2020-07-21","2021-01-05","2021-01-05","2020-10-15","2020-12-17","2021-04-02","2021-04-02","2020-07-08","2021-01-05","2020-07-08","2020-07-08","2020-07-08","2020-07-08","2020-10-22","2020-10-28","2020-10-28","2020-10-28","2020-07-02","2020-07-02","2020-07-02","2020-10-28","2020-10-28","2020-11-05","2020-11-30","2020-08-09","2021-02-05","2020-11-05","2021-01-05","2021-01-05","2021-01-05","2020-10-28","2020-10-29","2021-01-04","2019-12-06","2019-12-06"],"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":[["","","BUSPIRONE","TAB 5MG","","Select","Select",""],["","67544008015","ZOLOFT","TAB 100MG","14","Select","Select",""],["","","BUPROPN","TAB 300MG XL","","Select","Select",""],["","","SERTRALINE","TAB 50MG","","Select","Select",""],["","65862000899","METFORMIN","TAB 500MG","30","Select","Select",""],["","00781618667","CIPRO\/DEXA","SUS 0.3-0.1%","8","Select","Select",""],["","","HYDROXYZ","TAB 25MG","","Select","Select",""],["","","MEDROXYPR","TAB 10MG","","Select","Select",""],["","59762500801","MISOPROSTOL","TAB 200MCG","2","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","24208063110","NEO\/POLY\/HC","SOL 1% OTIC","10","Select","Select",""],["","","KETOROLAC","TAB 10MG","","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","","CVS","TAB 600MG","","Select","Select",""],["","","DICLOFENAC","TAB 75MG DR","","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","15","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":""}]}]}