{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TRACEY   M EATON","gend":1,"add":"136 CAMERON ST","city":"HAMPTON                       ","state":"VA","zip":"23663-2313","dob":"1979-11-26","age":"","mstatus":"","insh":4446321,"cliId":"","pno":7579448157,"cno":"","email":"","ename":"","eno":"","pphy":"BOWERS, LEO C","ppno":7578272127,"pcpadd":"26 WINE STREET,","pcpcity":"HAMPTON                       ","pcpstate":"VA","pcpzip":236693584,"pcpcounty":"","pcpid":"","pcpname":"OLD HAMPTON FAMILY MEDICAL ASSOCIATES PC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"TIDEWATER","aligned":"","ano":"","add2":"136 CAMERON ST","add3":"","madd1":"136 CAMERON ST","madd2":"","madd3":"","mcity":"HAMPTON                       ","mstate":"VA","mzip":"23663-2313","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F45.1","F90.2","F31.31","F41.1","F33.2","A41.9","G40.901","J96.01","J81.0","J69.0","G93.49","F10.231","E87.4","I10","F12.10","F17.210","Z79.82","K59.00","G93.40","F10.10","D72.829","R56.9","E87.2","R00.0","R68.89","I31.3","I51.7","J90","R10.84","R07.9","I63.9","R06.02","D72.823","I67.82","R26.89","R53.1"],"date":["2020-01-15","2020-01-15","2020-01-15","2020-01-15","2020-04-19","2020-04-22","2020-04-28","2020-04-28","2020-04-28","2020-04-22","2020-04-22","2020-04-22","2020-04-22","2020-04-28","2020-04-28","2020-04-22","2020-04-22","2020-04-22","2020-04-28","2020-04-28","2020-04-28","2020-04-28","2020-04-28","2020-04-28","2020-04-28","2020-04-22","2020-04-22","2020-04-22","2020-04-22","2020-04-23","2020-04-28","2020-04-23","2020-04-28","2020-04-25","2020-04-28","2020-04-28"],"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":[]},{"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":[["","16714035502","LEVETIRACETA","TAB 500MG","60","Select","Select",""],["","16714087602","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","11534016503","FOLIC","TAB 1MG","30","Select","Select",""],["","65862050301","AMOX\/K","TAB 875-125","4","Select","Select",""],["","00904645780","DOK","CAP 100MG","30","Select","Select",""],["","70677003101","SM","DIS 14MG\/24H","28","Select","Select",""],["","00904549213","THERA-M","TAB ","30","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":""}]}]}