{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIMAHSNAWS O","gend":1,"add":"HSA 825EVA YEL","city":"SUFFOLK","state":"VA","zip":"23434-9998","dob":"1982-03-29","age":"","mstatus":"","insh":"85300210*73","cliId":"","pno":"33\/7576629-9","cno":"757\/515-3756","email":"","ename":"","eno":"","pphy":"HUGHES, JOHNSIE B NP","ppno":"757\/484-7248","pcpadd":"2897 BRIDGE RD","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23435,"pcpcounty":"","pcpid":"","pcpname":"NANSEMOND SUFFOLK FAMILY PRACTICE","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":["R60.9","M79.671","M79.672","F33.2","F33.1","R06.02","Z68.42","R00.2","E66.01","M25.561","J06.9","Z20.828","J00.","Z72.0","R55.","R07.89","Z87.19","R60.0","F41.9","F32.9","R13.19","R10.826","K44.9","F17.210","F45.8","Z68.41","Z80.0","S86.911A","M79.675","S90.112A","M79.89","Z87.891","R13.10","M22.2X1"],"date":["2019-05-21","2019-05-21","2019-05-21","2019-08-13","2019-07-02","2020-02-12","2020-02-12","2020-02-12","2020-02-12","2020-06-22","2020-10-09","2020-10-09","2020-09-15","2020-09-15","2019-06-11","2019-06-11","2019-06-11","2019-06-11","2019-07-03","2019-07-03","2019-06-17","2019-06-17","2019-06-17","2019-06-17","2019-12-03","2019-06-17","2019-06-17","2021-05-27","2021-12-19","2021-12-19","2021-12-19","2021-12-19","2019-12-03","2020-06-29"],"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":[["","65162046510","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","42","Select","Select",""],["","70010013901","NAPROXEN","TAB 500MG","20","Select","Select",""],["","","MELOXICAM","TAB 7.5MG","","Select","Select",""],["","","BENZONATATE","CAP 100MG","","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":""}]}]}