{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROBERT M BERNDT","gend":0,"add":"2900 IDLEWOOD AVE APT 1","city":"RICHMOND","state":"VA","zip":"23221-9998","dob":"1975-07-19","age":"","mstatus":"","insh":"2328238*01","cliId":"","pno":8042692848,"cno":8042692848,"email":"","ename":"","eno":"","pphy":"AKERS-WHITE, LATANIA MD","ppno":8045543464,"pcpadd":"110 NORTH ROBINSON STREET SUITE 101,","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":8043674246,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","G62.9","R41.82","R45.1","R40.4","H57.04","R41.0","R56.9","R61.","G93.41","R74.8","E87.2","D72.829","F13.10","G40.89","Q66.91","Q66.92","B35.1","R60.9","F28.","F11.90","T65.891A","I10.","K75.89","F15.980","G90.9","F19.90","Z20.822","Z00.00","Z11.3","Z13.220"],"date":["2023-06-18","2021-04-23","2022-01-02","2022-01-02","2022-01-03","2022-01-02","2022-01-02","2022-01-02","2022-01-02","2022-01-02","2022-01-02","2022-01-02","2022-01-02","2022-01-02","2022-01-19","2022-01-19","2022-01-19","2022-01-19","2022-01-19","2022-01-01","2022-01-01","2022-01-01","2022-01-01","2022-01-01","2022-01-01","2022-01-01","2022-01-01","2022-01-01","2021-03-03","2021-03-03","2021-03-03"],"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":[["","00536111825","ARTH PAIN","CRE 0.00075","57","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","4","Select","Select",""],["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","65162010250","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","65162069890","GABAPENTIN SOL","250\/5ML","540","Select","Select",""],["","65162010250","GABAPENTIN CAP","300MG","90","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":""}]}]}