{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   ARUALSELWOB E","gend":1,"add":"EGAP 915RD DOOW","city":"NEWPORT NEWS","state":"VA","zip":"23602-9998","dob":"1985-06-12","age":"","mstatus":"","insh":"2885110*53","cliId":"","pno":"85\/7577000-0","cno":"","email":"","ename":"","eno":"","pphy":"HILSINGER, KATHERINE L MD","ppno":"757\/874-2229","pcpadd":"101 EATON ST SUITE 300","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":23669,"pcpcounty":"","pcpid":"","pcpname":"MID ATLANTIC WOMENS CARE PLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R35.0","N32.81","N34.2","Z76.89","G47.33","E66.9","D80.2","G47.00","H66.90","Z20.828","Z11.59","N04.8","N18.9","E66.09","N76.0","R35.1","F32.9","F60.3","G47.419","R44.2","G47.19","Z88.5","Z68.41","E66.01","R06.02","G47.61","J01.00","R05.","I10.","N30.91","R82.89","R42.","Z13.1","Z13.21","N89.0","R06.00","R53.81","K64.9","R10.31","N94.6","N92.0","R10.2","H60.93","N83.01","K64.8","K66.0","R39.15","Z23.","F43.22","Z13.220","Z83.3","N93.9","Z32.02","Z01.89","N83.201","Z12.4","Z01.411"],"date":["2021-02-19","2021-02-19","2021-02-19","2021-02-19","2021-06-17","2021-05-18","2021-05-18","2021-05-18","2020-08-05","2021-11-11","2020-08-05","2021-11-10","2021-11-10","2021-11-10","2020-09-24","2020-09-24","2021-09-21","2021-09-21","2021-05-18","2021-05-18","2021-05-18","2021-05-18","2021-05-18","2021-06-17","2020-07-17","2021-05-17","2021-05-28","2021-05-28","2021-05-28","2020-09-24","2020-09-24","2021-11-11","2021-11-11","2021-11-11","2020-04-07","2020-04-07","2021-03-02","2019-02-04","2019-10-07","2019-10-07","2019-10-07","2019-03-11","2019-01-28","2019-01-28","2019-03-05","2019-10-18","2019-10-18","2019-01-17","2019-02-07","2019-09-12","2019-09-12","2019-10-07","2019-09-23","2019-10-07","2019-01-30","2019-01-30","2019-01-30"],"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":{"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":[["","50111064801","FLUOXETINE","CAP 20MG","90","Select","Select",""],["","31722070090","LOSARTAN","TAB 25MG","30","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","16729031901","OXYBUTYNIN","TAB 15MG ER","30","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","57237007810","ONDANSETRON","TAB 8MG ODT","9","Select","Select",""],["","13107008305","LORAZEPAM","TAB 0.5MG","15","Select","Select",""],["","60432046400","LIDOCAINE","SOL 2% VISC","100","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":""}]}]}