{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ERRIKA LOWE","gend":1,"add":"941 19TH STREET                                             ","city":"NEWPORT NEWS                  ","state":"VA","zip":"23607-5334","dob":"1981-06-23","age":"","mstatus":"","insh":10232085,"cliId":"","pno":7573294136,"cno":7573294136,"email":"","ename":"","eno":"","pphy":"BOWERS, LEO C                                               ","ppno":"","pcpadd":"26 WINE STREET","pcpcity":"HAMPTON                       ","pcpstate":"VA","pcpzip":236693584,"pcpcounty":"","pcpid":"P9058601","pcpname":"EAST END PHYSICIANS","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"TIDEWATER","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"941 19TH STREET                                             ","madd2":"                                                            ","madd3":"","mcity":"NEWPORT NEWS                  ","mstate":"VA","mzip":"23607-5334","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z20.2","O09.522","O35.1XX0","Z3A.15","O28.5","O09.529","Z36.2","Z3A.17","Z36.9","Z3A.18","O28.9","Z3A.21","O24.410","Z3A.29","Z23","Z3A.28","O36.5930","Z3A.34","Z03.818","Z11.59","Z39.1","Z34.82","Z34.83","O46.90","Z3A.00","O60.00","O80","Z37.0","O98.82","O71.4","O99.824","A74.9","O13.4","Z3A.39","Q98.5","Z39.2"],"date":["2020-02-13","2020-04-16","2020-08-23","2020-03-09","2020-03-18","2020-03-09","2020-03-18","2020-03-18","2020-06-08","2020-03-27","2020-04-16","2020-04-16","2020-06-08","2020-06-08","2020-06-08","2020-06-08","2020-07-20","2020-07-20","2020-08-06","2020-08-06","2020-08-11","2020-08-11","2020-08-22","2020-08-18","2020-08-22","2020-08-19","2020-08-22","2020-08-23","2020-08-22","2020-08-23","2020-08-23","2020-08-22","2020-08-22","2020-08-23","2020-08-22","2020-10-07"],"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":[["","67877032105","IBUPROFEN","800MG","30","Select","Select",""],["","00536106210","STOOL","100MG","20","Select","Select",""],["","67877032105","IBUPROFEN ","TAB 800MG","30","Select","Select",""],["","00536106210","STOOL ","CAP 100MG","20","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","",""],["N\/A","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":""}]}]}