{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" YNOHTNAODASOR M","gend":0,"add":"SO 711TS EGA","city":"VIRGINIA BEACH","state":"VA","zip":23462,"dob":"1986-07-04","age":"","mstatus":"","insh":"10115728","cliId":"","pno":"3275763746","cno":"","email":"","ename":"","eno":"","pphy":"LAW, KATHERINE PINCKNEY","ppno":7572364736,"pcpadd":"5320 PROVIDENCE RD ,STE 301","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23464,"pcpcounty":"","pcpid":"","pcpname":"SENTARA FAMILY MED PRIMARY CAR","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"117 OSAGE ST                                      ","madd2":"                                                  ","madd3":"","mcity":"VIRGINIA BEACH           ","mstate":"VA","mzip":"23462-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.0","L40.9","E78.2","Z00.00","E11.9","F20.3","F41.1","J06.9","E11.65","R30.0","Q90.9","E66.9","Z79.4","Z99.81","R31.0","L03.116","R73.03","F25.1","M25.559","R10.84","N32.89","R35.0","M54.9","R39.15","R31.9","Z23","R33.9","R93.41","N35.811","N39.0","Q21.0","Z91.81"],"date":["2021-11-21","2021-06-07","2022-07-07","2022-07-07","2022-07-07","2022-06-02","2022-06-02","2022-01-19","2021-06-18","2022-06-29","2022-07-07","2022-07-07","2021-06-18","2021-06-18","2022-07-19","2021-09-28","2021-06-18","2022-07-07","2022-01-06","2021-10-29","2022-07-19","2021-10-29","2021-10-29","2021-10-29","2021-10-29","2022-07-07","2022-06-29","2022-07-19","2022-06-29","2022-07-07","2022-07-07","2022-07-07"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"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":[["","00169413013","OZEMPIC","INJ 4MG\/3ML","3","Select","Select",""],["","16729017001","ESCITALOPRAM","TAB 20MG","90","Select","Select",""],["","00093310953","AMOXICILLIN","CAP 500MG","12","Select","Select",""],["","99073070822","FREESTYLE    TES LITE","TES LITE","50","Select","Select",""],["","31722082830","ARIPIPRAZOLE","TAB 15MG","90","Select","Select",""],["","00074433902","HUMIRA","INJ 40MG\/0.8","2","Select","Select",""],["","68180063509","ATORVASTATIN","TAB 10MG","60","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","62332050606","AZELASTINE","DRO 0.0005","6","Select","Select",""],["","69238110005","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","70700010617","CLOBETASOL","OIN 0.0005","60","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16.00","Select","Select",""],["","65162027210","SMZ\/TMP","TAB 800-160","6.00","Select","Select",""],["","65862090801","CELECOXIB","CAP 100MG","60.00","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":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}