{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  EATNOIEKSINNED A ","gend":0,"add":"TSEW 804RD WEIV","city":"HAMPTON","state":"VA","zip":"23666-9998","dob":"2000-09-23","age":"","mstatus":"","insh":"46200210*44","cliId":"","pno":"-6676730","cno":"","email":"","ename":"","eno":"","pphy":"KEITH, JENNIFER A NP","ppno":"757\/316-5050","pcpadd":"209 VILLAGE AVE SUITE P","pcpcity":"YORKTOWN","pcpstate":"VA","pcpzip":23693,"pcpcounty":"","pcpid":"","pcpname":"Riverside Primary Care Kiln Creek","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J45.909","F95.2","F41.9","G47.9","L50.5","R00.0","L50.9","J30.89","J31.0","L29.9","T50.905S","F90.0","F84.0","F41.1","R21.","R86.8","K13.79","G47.00","L72.3","M94.0","M54.2","D70.9"],"date":["2021-08-25","2020-05-07","2020-05-07","2020-05-07","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2020-03-03","2020-03-03","2021-06-01","2019-11-02","2019-10-04","2019-10-04","2019-10-04","2019-03-19","2019-06-07","2019-06-07","2019-12-16"],"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":[["","","BUSPIRONE","TAB 15MG","","Select","Select",""],["","","EPINEPHRINE","INJ 0.3MG","","Select","Select",""],["","17772010130","TROKENDI","CAP 25MG","30","Select","Select",""],["","10702001250","HYDROXYZ","TAB 50MG","30","Select","Select",""],["","","LORATADINE","TAB 10MG","","Select","Select",""],["","","MONTELUKAST","TAB 10MG","","Select","Select",""],["","","XOLAIR","INJ 150MG\/ML","","Select","Select",""],["","","LEVOCETIRIZI","TAB 5MG","","Select","Select",""],["","","FEXOFENADINE","TAB 180MG","","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","50111043401","TRAZODONE","TAB 100MG","30","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","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":""}]}]}