{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NARTIA  C MCDONALD","gend":1,"add":"1709 GORDON AVE APT B","city":"RICHMOND","state":"VA","zip":"23224-9998","dob":"1982-10-28","age":"","mstatus":"","insh":"20063425*01","cliId":"","pno":"804\/803-9208","cno":"804\/803-9208","email":"","ename":"","eno":"","pphy":"KING, TONY R MD","ppno":"804\/230-4913","pcpadd":"1606 HULL ST STE A","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23224,"pcpcounty":"","pcpid":105617,"pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/233-1841","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R09.81","B34.9","F33.1","Z01.411","R42.","R07.9","Z01.419","Z12.4","Z85.41","Z90.710","R35.0","N89.8","R10.2","Z68.38"],"date":["2020-03-02","2020-03-02","2021-08-15","2021-03-17","2021-05-05","2020-09-02","2020-02-03","2020-02-03","2020-02-03","2020-02-03","2020-02-03","2020-02-03","2020-02-03","2020-02-03"],"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":[["","70710113908","FLUCONAZOLE ","150MG","2","Select","Select",""],["","50111033401","METRONIDAZOL ","500MG","14","Select","Select",""],["","63824005632","MUCINEX ","30-600ER","20","Select","Select",""],["","59779066209","TUSSIN ","15MG","20","Select","Select",""],["","16729020201","BUSPIRONE ","10MG","60","Select","Select",""],["","66993068130","OLANZAPINE ","5MG","30","Select","Select",""],["","65862067899","ALPRAZOLAM ","1MG","10","Select","Select",""],["","69097083412","SERTRALINE ","50MG","30","Select","Select",""],["","50111043401","TRAZODONE ","100MG","30","Select","Select",""],["","65162019050","NAPROXEN ","500MG","20","Select","Select",""],["","68382003516","VENLAFAXINE ","75MG ER","30","Select","Select",""],["","43547034106","RISPERIDONE ","1MG","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","",""],["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":""}]}]}