{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JENNIFER   L JENKINS","gend":1,"add":"24812 BLACK BRANCH ROAD","city":"STONY CREEK","state":"VA","zip":"23882-9998","dob":"1983-05-07","age":"","mstatus":"","insh":"1487624*01","cliId":"","pno":"804\/919-3586","cno":"","email":"","ename":"","eno":"","pphy":"AZMI, MALALAI MD","ppno":"434\/246-6100","pcpadd":"12454 HARTLEY STREET","pcpcity":"STONY CREEK","pcpstate":"VA","pcpzip":23882,"pcpcounty":"","pcpid":"","pcpname":"STONY CREEK COMMUNITY HEALTH CENTER","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/246-6137","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R51.","R15.9","M54.5","E78.5","F17.210","E66.09","Z68.34","Z01.419","Z32.02","R19.7","R10.9","R14.3","E66.9","N84.0","N93.9","N93.8","E55.9","D50.9","E04.2","E53.8","Z68.32","O26.899","O24.415","T14.8XXA","M54.32","M54.31","F32.9","E28.2","Z79.899","M25.552","Z09.","Z20.828","Z30.430","J06.9","K21.9","F17.200","E04.1","R11.0","M54.16","G44.82","G43.019","E66.01","N91.2","Z01.818","K58.9","H18.823","H52.13","H50.52","H35.363","R53.83","Z30.431","N93.0","N81.11","R82.90"],"date":["2020-02-20","2019-09-13","2021-08-30","2019-09-13","2021-11-15","2019-09-13","2020-03-12","2020-10-29","2021-02-22","2019-11-05","2019-11-05","2019-10-29","2020-03-12","2021-01-28","2021-04-08","2021-01-14","2021-11-15","2021-10-14","2021-10-14","2021-10-14","2021-11-15","2020-09-17","2020-09-17","2020-09-17","2020-09-17","2020-09-17","2020-09-17","2021-11-15","2020-09-17","2020-09-17","2021-01-28","2021-07-28","2021-02-22","2021-07-28","2021-10-22","2021-10-22","2021-11-15","2019-10-01","2019-09-27","2019-10-16","2019-10-16","2019-10-16","2020-03-12","2021-01-07","2020-02-20","2021-09-01","2021-09-01","2021-09-01","2021-09-01","2021-11-15","2021-03-22","2021-08-30","2021-08-30","2021-08-30"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"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":[]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","00406051205","OXYCOD\/APAP","TAB 5-325MG","6","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","90","Select","Select",""],["","","OMEPRAZOLE"," OMEPRAZOLE ","30","Select","Select",""],["","42571016142","AMOX\/K","TAB 500-125","14","Select","Select",""],["","00555088602","ESTRADIOL","TAB 1MG","14","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00555021110","NORETHIN","TAB 5MG","90","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","","DOXYCYCL","TAB 100MG","","Select","Select",""],["","","METHOCARBAM","TAB 750MG","","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""]]}},{"a":[]},{"a":[]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"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":"","a13":""}]}]}