{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRIANNA PARKER","gend":1,"add":"C\/O KIMBERLY PARKER                                         ","city":"SUFFOLK                       ","state":"VA","zip":"23435-2908","dob":"1997-07-20","age":"","mstatus":"","insh":10027199,"cliId":"","pno":7579670310,"cno":7579670310,"email":"","ename":"","eno":"","pphy":"BOWERS, JESSICA A                                           ","ppno":"","pcpadd":"1040 University Blvd Ste 205,Ste A","pcpcity":"Portsmouth                    ","pcpstate":"VA","pcpzip":237032650,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"TIDEWATER","aligned":"","ano":"","add2":"6732 BURBAGE LAKE CIRCLE                                    ","add3":"","madd1":"C\/O KIMBERLY PARKER                                         ","madd2":"6732 BURBAGE LAKE CIRCLE                                    ","madd3":"","mcity":"SUFFOLK                       ","mstate":"VA","mzip":"23435-2908","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F39","E03.9","F84.0","Z68.34"],"date":["2019-12-03","2020-11-20","2020-11-20","2020-11-20"],"priorHcc":["","","",""]}},{"a":[]}]},{"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":[]}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","13668021830","ARIPIPRAZOLE","10MG","90","Select","Select",""],["","58160088552","FLUARIX","2020-21","0.5","Select","Select",""],["","00781519192","LEVOTHYROXIN","137MCG","30","Select","Select",""],["","16714008110","HYDROXYZ","10MG","30","Select","Select",""],["","16714035201","FLUOXETINE","20MG","30","Select","Select",""],["","72305013730","EUTHYROX","137MCG","90","Select","Select",""],["","47781065990","LEVOTHYROXIN ","TAB 137MCG","90","Select","Select",""],["","13668021830","ARIPIPRAZOLE ","TAB 10MG","90","Select","Select",""],["","58160088552","FLUARIX ","INJ 2020-21","0.5","Select","Select",""],["","16714008110","HYDROXYZ ","TAB 10MG","90","Select","Select",""],["","16714035201","FLUOXETINE ","CAP 20MG","30","Select","Select",""],["","72305013730","EUTHYROX ","TAB 137MCG","90","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}