{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN PRUITTE","gend":0,"add":"7411 HAWTHORNE AVE RM 312","city":"RICHMOND","state":"VA","zip":"23227-9998","dob":"1980-08-11","age":"","mstatus":"","insh":"2344328*01","cliId":"","pno":8045869063,"cno":8045869063,"email":"","ename":"","eno":"","pphy":"PAUL, CHRISTINE E MD","ppno":8042307777,"pcpadd":"4730 N SOUTHSIDE PLAZA,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23224-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8042302071,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.3","F11.20","F25.1","F31.13","F11.129","F33.2","F11.90","Z72.0","R45.1","V62.84","F91.9","F11.10","F32.9","J44.9","F17.200","Z79.51","Z20.822","F19.10","F19.94","F10.99","NO DATA","T40.1X1A","F25.0","F33.1","F15.10","B34.9","Z20.828","D72.829","R00.0","J18.9","L03.116","M79.662","D64.9","F43.10","K04.7","J45.20","R11.2","G89.29","F43.25","F25.9","M54.41","J30.9","T22.052A","F17.210","F41.1","I49.8","M54.5","R04.2","H66.001","Z00.8","F33.9","F10.29","T50.904A","Z03.818","M54.40","M54.9","F06.2"],"date":["2021-10-14","2022-07-20","2021-08-18","2021-06-23","2021-06-28","2021-10-20","2022-08-22","2021-12-16","2021-01-25","2022-08-18","2021-02-05","2021-07-12","2021-07-14","2021-08-26","2021-07-12","2021-07-12","2021-07-13","2021-10-14","2021-08-11","2021-08-11","2022-08-22","2022-08-16","2021-02-14","2021-07-04","2021-08-18","2021-10-07","2021-12-16","2021-01-07","2021-02-05","2021-02-15","2021-07-05","2021-07-05","2021-06-27","2021-10-14","2022-06-09","2022-06-09","2022-08-02","2022-08-02","2021-01-25","2021-02-04","2021-08-26","2022-08-18","2022-08-18","2022-08-18","2022-08-22","2021-01-06","2021-01-26","2021-01-31","2021-12-16","2021-02-06","2021-08-08","2021-08-08","2022-08-16","2021-06-18","2021-08-26","2021-08-26","2021-10-08"],"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":[["","47781035703","BUPREN\/NALOX","MIS 8-2MG","28","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","60","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00536302934","NICOTINE POL","GUM 2MG ORIG","80","Select","Select",""],["","16714047701","AMOX\/K CLAV","TAB 500-125","5","Select","Select",""],["","11822061675","RA NICOTINE","GUM 2MG","80","Select","Select",""],["","00781717612","NALOXONE","SPR 4MG","2","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","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":""}]}]}