{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   ANOJIDSEVARG C","gend":1,"add":"NIF 371QS YELD","city":"HAMPTON","state":"VA","zip":"23666-9998","dob":"1987-11-06","age":"","mstatus":"","insh":"9467110*30","cliId":"","pno":"62\/7571274-8","cno":"","email":"","ename":"","eno":"","pphy":"SUTTON, THADDEUS MD","ppno":"757\/251-2170","pcpadd":"850 ENTERPRISE PARKWAY SUITE 2200","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":23666,"pcpcounty":"","pcpid":"","pcpname":"Riverside Center for Internal & Family Medicine","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":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K08.89","A09.","F43.20","F43.10","S01.511A","F32.9","F41.9","Z79.899","F10.20","M75.42","M25.512","K02.9","F17.210","NO DATA","H04.121","H04.122","H52.13","H52.222","R22.32","D64.9","R73.09","E53.8","E55.9","Z13.220","N39.0","J02.9","M25.562","M25.571","T14.8XXA","V58.89","M54.5","M26.621","M26.69","M54.2","M54.9","G89.29","V87.7XXA","Y92.9","Y93.89","B96.89","N30.01","R20.8"],"date":["2020-03-20","2020-08-07","2020-12-09","2021-05-26","2021-07-17","2021-07-17","2021-07-17","2021-07-17","2020-05-18","2021-03-25","2021-03-25","2020-03-20","2020-03-20","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2020-03-30","2019-08-08","2019-07-07","2019-07-07","2019-07-07","2019-07-11","2019-07-11","2019-08-03","2019-08-03","2019-01-15","2019-01-15","2019-01-15","2019-01-15","2019-01-15","2019-01-15","2019-07-19","2019-06-07","2019-06-07"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"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":[["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","","TRAMADOL","TAB 50MG","","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","","AMOXICILLIN","TAB 500MG","","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":""}]}]}