{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ORLANDO   F ESTERS SR","gend":0,"add":"9550 SELBY PL","city":"NORFOLK","state":"VA","zip":"23503-9998","dob":"1962-09-22","age":"","mstatus":"","insh":"2050610*01","cliId":"","pno":"757\/675-9545","cno":"757\/675-9545","email":"","ename":"","eno":"","pphy":"FEE, ERIC MD","ppno":"757\/587-0157","pcpadd":"7924 CHESAPEAKE BLVD","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23518,"pcpcounty":"","pcpid":670139,"pcpname":"Bayview Medical Center","plan":"OHP","program":"ACA","lob":"Individual","region":"TIDEWATER","aligned":"","ano":"757\/313-0070","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":["C20.","N48.9","K65.1","C79.11","I10.","D63.0","N52.9","F10.10","I25.2","Z93.3","Z93.6","Z45.2","Z87.440","Z91.81","R82.998","Z85.048","C18.9","M79.671","L02.215","T85.698A","T85.618A","R73.9","R10.2","K43.5","N43.3","Z90.79","Z82.49","Z83.3","Z79.899","Z92.21","Z93.2","R18.8","Z46.82","C79.9","K59.00","N28.89","Z85.038","Z90.49","Z98.890","C18.7","R19.09","Z85.51","K60.4","K61.1","L90.5","L02.211","K80.20","N17.9","I24.1","Z20.828","E86.0","R10.9","L08.89","Z79.891","S31.109A"],"date":["2020-06-12","2020-02-14","2021-05-25","2020-06-12","2020-08-02","2020-06-12","2020-08-31","2020-06-12","2020-08-02","2020-11-06","2020-06-12","2020-06-12","2020-06-12","2020-06-12","2020-08-31","2020-08-03","2020-11-17","2020-11-30","2020-07-27","2020-02-14","2020-02-13","2020-02-13","2020-02-13","2020-11-06","2020-02-13","2020-02-13","2020-08-02","2020-08-02","2020-08-02","2020-04-30","2020-11-06","2021-04-26","2021-05-03","2020-02-13","2020-05-27","2020-11-06","2020-11-06","2020-11-06","2020-08-04","2021-06-23","2020-02-17","2020-02-17","2020-04-30","2020-04-30","2020-04-30","2020-08-02","2020-08-02","2020-08-02","2020-08-02","2020-08-02","2020-08-02","2020-08-02","2020-04-30","2020-04-30","2020-02-13"],"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":[["","67877019905","AMLODIPINE","10MG","30","Select","Select",""],["","43547035610","LISINOPRIL","40MG","30","Select","Select",""],["","11822393550","RA","","255","Select","Select",""],["","42858010201","OXYCOD\/APAP","5-325MG","20","Select","Select",""],["","60505004101","ETODOLAC","400MG","20","Select","Select",""],["","80777027398","MODERNA","COVID-19","0","Select","Select",""],["","43547035610","LISINOPRIL ","40MG","30","Select","Select",""],["","67877019905","AMLODIPINE ","10MG","30","Select","Select",""],["","11822393550","RA ","","255","Select","Select",""],["","42858010201","OXYCOD\/APAP ","5-325MG","20","Select","Select",""],["","60505004101","ETODOLAC ","400MG","20","Select","Select",""],["","80777027398","MODERNA ","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":""}]}]}