{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MATTHEW   B DRUMWRIGHT","gend":0,"add":"1417 GARWOOD AVE","city":"VIRGINIA BEACH","state":"VA","zip":"23455-9998","dob":"1967-03-27","age":"","mstatus":"","insh":"1876430*01","cliId":"","pno":"757\/363-1721","cno":"757\/363-1721","email":"","ename":"","eno":"","pphy":"GRAHAM, MARY O MD","ppno":"757\/460-1207","pcpadd":"1147 INDEPENDENCE BLVD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23455,"pcpcounty":"","pcpid":670145,"pcpname":"","plan":"OHP","program":"ACA","lob":"Individual","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":["R51.9","Z20.828","R52.","J45.41","L40.9","Z11.1","L25.9","L08.0","Z12.11"],"date":["2020-12-31","2020-12-31","2020-12-31","2020-12-31","2021-04-26","2021-04-26","2020-01-14","2020-01-14","2020-08-31"],"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":[["","57894064001","TREMFYA","100MG\/ML","1","Select","Select",""],["","00143924920","AMOX\/K","875-125","20","Select","Select",""],["","65862021150","MINOCYCLINE","100MG","14","Select","Select",""],["","00173068220","VENTOLIN","","18","Select","Select",""],["","67877019805","AMLODIPINE","5MG","-30","Select","Select",""],["","31722071130","SILDENAFIL","100MG","1","Select","Select",""],["","59746017506","PREDNISONE","20MG","12","Select","Select",""],["","62332025118","AZITHROMYCIN","250MG","6","Select","Select",""],["","59676058015","JANSSEN","COVID-19","0","Select","Select",""],["","57894064001","TREMFYA ","100MG\/ML","1","Select","Select",""],["","65862021150","MINOCYCLINE ","100MG","14","Select","Select",""],["","00143924920","AMOX\/K ","875-125","20","Select","Select",""],["","00173068220","VENTOLIN ","","18","Select","Select",""],["","67877019805","AMLODIPINE ","5MG","30","Select","Select",""],["","31722071130","SILDENAFIL ","100MG","1","Select","Select",""],["","62332025118","AZITHROMYCIN ","250MG","6","Select","Select",""],["","59746017506","PREDNISONE ","20MG","12","Select","Select",""],["","59676058015","JANSSEN ","COVID-19","0","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":""}]}]}