{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KENNETH FORTE","gend":0,"add":"7748 MIDLOT HIAN TPKE","city":"RICHMOND","state":"VA","zip":"23235-9998","dob":"1974-05-19","age":"","mstatus":"","insh":"2195957*01","cliId":"","pno":8042529943,"cno":8042529943,"email":"","ename":"","eno":"","pphy":"COOK, PATRICIA MD","ppno":8047832505,"pcpadd":"517 W GRACE ST,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23220-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8046491635,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R94.31","D69.6","G40.909","F10.10","R56.9","F10.20","E83.42","E83.39","F10.231","K70.10","F17.210","Z91.11","NO DATA","E87.5","I10.","E87.6","Z91.19","V58.69","Z79.899","Z91.128","Z86.73","F10.239","D69.59","F10.229","E78.5","E87.1","G40.509","K92.1","R19.5","R57.8","N17.9","F10.230","D61.818","K70.30","Z79.82","Z68.21","R57.9","E87.2","R57.1","Z20.822","J44.9","F41.9","Z96.642","F17.200","R17.","K70.11","D68.9","F10.99","R74.8","E16.2","Z66.","F10.129","I49.3","R00.0","A41.9","R65.21","K76.7","N39.0","K76.0","K44.9","Z91.14","R10.9","Y90.8","R16.0","Z59.0","Z98.890","Z98.52","K85.90","R07.9","N20.0","K29.20","R41.82","R11.2","E87.3","R65.10","D62.","E86.0","D72.829","R45.1","E87.0","E83.51","K21.9","F19.939","F32.9","I47.2","Z53.29","F12.90","I77.810","E43.","Z56.0","Z68.22","K75.9","R53.1","R42.","T68.XXXA","R07.89","E87.8","I49.2","K22.10","F12.10","R11.0","I49.8","Z68.23","R26.81","Y90.1","I45.81","F43.21","R39.81","Z71.6","R52.","R06.02"],"date":["2022-04-04","2021-07-09","2022-03-29","2022-04-01","2022-04-14","2022-04-14","2022-04-13","2022-04-08","2022-02-07","2022-04-14","2022-04-14","2021-03-03","2022-04-13","2021-03-03","2022-02-07","2022-04-13","2021-04-17","2021-03-03","2022-01-25","2021-03-03","2022-01-25","2022-03-29","2021-04-17","2021-04-17","2022-01-25","2022-04-13","2022-01-25","2022-04-02","2022-04-02","2021-08-21","2022-04-13","2021-08-21","2021-12-07","2022-04-13","2022-01-25","2021-12-10","2022-04-13","2022-04-01","2022-03-29","2022-03-29","2022-03-29","2022-04-14","2022-02-07","2022-02-07","2022-04-13","2022-04-13","2022-04-13","2022-04-13","2022-04-13","2021-03-17","2021-03-17","2021-10-11","2022-02-07","2022-02-07","2022-03-29","2022-03-29","2022-03-29","2022-03-29","2022-03-29","2022-04-01","2021-02-23","2021-02-16","2021-02-23","2021-02-28","2021-02-28","2021-02-28","2021-06-11","2021-02-14","2022-01-26","2021-02-14","2021-02-23","2022-01-15","2022-01-25","2021-08-16","2021-08-14","2021-08-14","2021-08-14","2021-08-14","2022-01-15","2022-03-29","2022-04-08","2022-04-14","2021-08-14","2021-07-06","2022-01-26","2022-01-25","2022-01-25","2022-01-25","2022-02-07","2022-02-07","2022-02-07","2021-01-19","2021-04-17","2021-01-22","2021-01-28","2021-02-14","2021-06-11","2021-06-11","2021-08-20","2021-10-07","2021-10-07","2021-12-08","2022-01-26","2021-10-11","2021-12-07","2021-06-11","2022-04-07","2021-01-19","2021-01-23","2021-03-03","2022-01-25"],"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":[]},{"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":[["","00781261305","AMOXICILLIN","CAP 500MG","20","Select","Select",""],["","68180011316","LEVETIRACETA","TAB 500MG","60","Select","Select",""],["","57896060101","THERA-TABS","TAB ","30","Select","Select",""],["","68180035103","SERTRALINE","TAB 25MG","30","Select","Select",""],["","79854020010","VITAMIN B-1","TAB 100MG","30","Select","Select",""],["","00904053060","TAB-A-VITE","TAB ","30","Select","Select",""],["","65649030302","XIFAXAN","TAB 550MG","60","Select","Select",""],["","96295013892","VITAMIN B1","TAB 100MG","30","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","80681004002","MELATONIN","TAB 5MG","30","Select","Select",""],["","65162036111","FOLIC ACID","TAB 1MG","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":""}]}]}