{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ZAKIYYAH   S JONES","gend":1,"add":"1407 OLD BRONZE ROAD","city":"HENRICO","state":"VA","zip":"23231-9998","dob":"1981-07-08","age":"","mstatus":"","insh":"5991196*01","cliId":"","pno":"804\/801-8797","cno":"804\/222-0892","email":"","ename":"","eno":"","pphy":"JENKINS JR, JAMES MD","ppno":"804\/780-0840","pcpadd":"719 N 25TH ST","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23223,"pcpcounty":"","pcpid":"","pcpname":"VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/780-0862","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R11.2","R00.1","T40.7X1A","K52.9","M79.606","M54.5","J45.909","G89.29","F31.0","H60.333","F17.210","H92.09","F11.20","F31.9","F41.1","F43.10","M54.9","G43.709","M51.26","Z01.419","Z11.3","F90.2","M25.561","V89.2XXA","Z04.9","M25.562","M94.261","M94.262","R94.31","J20.9","F33.2","F10.20","R10.9","J45.901","F32.3","F10.129"],"date":["2020-08-04","2020-08-04","2020-08-04","2020-08-04","2021-06-26","2021-06-26","2021-06-26","2021-06-26","2020-05-21","2020-08-19","2020-08-19","2020-08-19","2021-08-29","2021-06-03","2021-06-03","2021-06-03","2021-06-26","2021-11-12","2021-11-12","2020-03-02","2020-03-02","2021-08-30","2021-07-07","2021-07-07","2021-06-03","2020-03-19","2020-03-19","2020-03-19","2020-08-04","2020-01-18","2019-07-11","2019-06-14","2019-06-15","2019-06-15","2019-06-15","2019-05-13"],"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":[["","","SUBOXONE","MIS 8-2MG","","Select","Select",""],["","","LAMOTRIGINE","TAB 25MG","","Select","Select",""],["","","BUPREN\/NALOX","MIS 8-2MG","","Select","Select",""],["","59651039001","BUSPIRONE","TAB 7.5MG","90","Select","Select",""],["","00378230201","PRAZOSIN","CAP 2MG","60","Select","Select",""],["","00115180301","HYDROXYZ","CAP 25MG","10","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","60","Select","Select",""],["","00904673080","ACETAMIN","TAB 500MG","120","Select","Select",""],["","","NARCAN","SPR ","","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","00555007102","ISONIAZID","TAB 300MG","30","Select","Select",""],["","13107003134","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","65862014636","SUMATRIPTAN","TAB 25MG","15","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","","ONDANSETRON","TAB 8MG ODT","","Select","Select",""],["","00245010811","FERROUS","TAB 325MG EC","90","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","20","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","10006073017","VITAMIN","TAB 50MG","30","Select","Select",""],["","","PRAMIPEXOLE","TAB 0.25MG","","Select","Select",""],["","50111043401","TRAZODONE","TAB 100MG","30","Select","Select",""],["","","ARTHRTS","TAB 650MG","","Select","Select",""],["","43598044874","NICOTINE","DIS 21MG\/24H","14","Select","Select",""],["","","CIPRO","SUS OTIC","","Select","Select",""],["","","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","00378623201","CITALOPRAM","TAB 20MG","15","Select","Select",""],["","","LOPERAMIDE","CAP 2MG","","Select","Select",""],["","","MELOXICAM","TAB 7.5MG","","Select","Select",""],["","","CIPRODEX","SUS 0.3-0.1%","","Select","Select",""],["","","NEO\/POLY\/HC","SUS 1% OTIC","","Select","Select",""],["","","CIPRO\/DEXA","SUS 0.3-0.1%","","Select","Select",""],["","","DICYCLOMINE","CAP 10MG","","Select","Select",""],["","68462013281","NORETH\/ETHIN","TAB 44581","21","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":""}]}]}