{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CLARENCE RICHARDSON","gend":0,"add":"900 E MARSHALL ST","city":"RICHMOND","state":"VA","zip":"23219-9998","dob":"1973-01-07","age":"","mstatus":"","insh":"2323519*01","cliId":"","pno":8045466563,"cno":8045466563,"email":"","ename":"","eno":"","pphy":"HUGHES, JON NP","ppno":4348573600,"pcpadd":"414 PARK AVE,","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24541-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4348573601,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F12.20","J01.90","F31.81","F43.10","R44.0","M79.644","F33.2","F11.90","F17.200","R56.9","R40.4","R45.6","R00.0","W19.XXXA","F25.1","F90.2","F32.9","G40.89","F41.9","F33.9","F43.12","T78.40XA","K21.9","Z72.0","F51.01","F41.1","F33.1","F14.10","J96.01","N39.0","F31.32","S62.664A","Y92.89","E87.5","Z20.822","F31.5","K29.70","J96.02","J69.0","E87.2","N17.9","N30.90","E87.6","F12.10","Z88.1","Z88.2","R00.2","S62.609A","V62.84","F29.","F05.","I10.","M21.942","M21.932","J30.2","Z71.6","F17.210","F31.4","F22.","T40.1X1A","Z79.899","T50.901A","R45.89","Z53.21","R53.81","F25.0"],"date":["2021-08-30","2021-08-06","2023-06-06","2021-10-24","2022-03-15","2022-04-18","2021-01-20","2021-01-20","2021-01-20","2021-04-11","2021-04-10","2021-04-10","2021-04-10","2021-04-10","2022-03-27","2022-04-24","2021-01-20","2021-04-10","2021-10-01","2021-10-01","2021-10-11","2022-03-31","2023-06-04","2021-08-06","2022-04-22","2022-04-22","2021-01-10","2021-04-11","2021-04-11","2021-04-11","2021-10-03","2022-04-14","2022-04-14","2021-04-10","2023-06-23","2021-09-13","2021-02-04","2021-04-10","2021-04-10","2021-04-10","2021-04-10","2021-04-10","2021-04-10","2021-04-10","2021-04-10","2021-04-10","2021-06-17","2022-04-11","2021-01-18","2023-06-18","2021-01-19","2023-06-23","2021-04-07","2021-04-07","2021-04-07","2021-04-07","2023-06-04","2022-05-02","2023-06-23","2023-06-04","2023-06-04","2023-06-04","2023-06-19","2023-06-14","2023-06-19","2023-06-20"],"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":[["","67877024901","QUETIAPINE","TAB 50MG","30","Select","Select",""],["","59651039001","BUSPIRONE","TAB 7.5MG","60","Select","Select",""],["","67877024901","QUETIAPINE TAB","50MG","30","Select","Select",""],["","59651039001","BUSPIRONE TAB","7.5MG","60","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":""}]}]}