{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN   R JONES","gend":0,"add":"2984 S LYNNHAVEN RD STE 118","city":"VIRGINIA BEACH","state":"VA","zip":"23452-9998","dob":"1960-03-01","age":"","mstatus":"","insh":"1804660*01","cliId":"","pno":"757\/724-1166","cno":"757\/724-1166","email":"","ename":"","eno":"","pphy":"WADDELL, DAVID T MD","ppno":"","pcpadd":"STE A 1856 COLONIAL MED CT","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23454,"pcpcounty":"","pcpid":143803,"pcpname":"Waddell Family Medicine PC","plan":"OHP","program":"ACA","lob":"Individual","region":"TIDEWATER","aligned":"","ano":"757\/724-1166","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/962-1185","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R79.89","R94.5","F41.9","I10.","Z13.89","R53.83","R11.0","R49.0","J31.0","R10.9","R94.31","Z20.822","B17.9","G47.00","Z00.00","Z68.28","Z12.11","R00.2","R09.89","N30.00","Z90.49","R10.84","Z01.82","Z13.21","Z13.220","Z13.0","Z13.29","Z13.88","Z77.120","Z12.5","F41.1","R20.2","L53.9","K42.9","E78.5","M79.672","M20.22","M79.671","M20.21","N40.1","I47.1","R35.1","N13.8","I51.89"],"date":["2021-03-22","2021-03-22","2021-07-29","2021-10-26","2021-03-22","2021-07-20","2021-07-20","2021-05-26","2021-05-26","2021-07-20","2021-07-20","2021-08-16","2021-03-18","2021-04-26","2021-05-14","2021-05-14","2021-05-23","2021-10-26","2021-07-20","2021-07-20","2021-07-20","2021-07-20","2021-04-08","2021-04-08","2021-04-08","2021-04-08","2021-04-08","2021-04-08","2021-04-08","2021-05-14","2021-04-08","2021-04-08","2021-04-08","2021-04-08","2021-05-14","2021-05-17","2021-05-17","2021-05-17","2021-05-17","2021-11-01","2021-08-11","2021-11-01","2021-11-01","2021-11-02"],"priorHcc":["","","",null,"","","","","","","","","","","","","",null,"","","","","","","","","","","","","","","","","","","","","",null,"",null,null,null]}},{"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":[["","68382013201","TAMSULOSIN","0.4MG","30","Select","Select",""],["","68645057054","CITALOPRAM","20MG","30","Select","Select",""],["","69315090501","LORAZEPAM","1MG","30","Select","Select",""],["","43547028111","ESCITALOPRAM","10MG","30","Select","Select",""],["","67877021901","CEPHALEXIN","500MG","14","Select","Select",""],["","68382013201","TAMSULOSIN ","CAP 0.4MG","60","Select","Select",""],["","69315090501","LORAZEPAM ","TAB 1MG","30","Select","Select",""],["","68645057054","CITALOPRAM ","TAB 20MG","30","Select","Select",""],["","67877021901","CEPHALEXIN ","CAP 500MG","14","Select","Select",""],["","43547028111","ESCITALOPRAM ","TAB 10MG","30","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","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","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":""}]}]}