{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KEMEESHA  A WHITE","gend":1,"add":"45 CUSHING ST","city":"PORTSMOUTH","state":"VA","zip":23702,"dob":"1984-10-23","age":"","mstatus":"","insh":"1492774*01","cliId":"","pno":"757\/837-8806","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"757\/738-1225","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23702,"pcpcounty":"","pcpid":"","pcpname":"AIRLINE BOULEVARD MEDICAL ASSOCIATES","plan":"OHP","program":"Medicaid","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/448-1037","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z23.","Z68.41","I10.","E11.9","E66.01","J30.89","J30.2","R06.02","U07.1","J96.01","J12.89","J96.00","R05.","J18.9","R07.9","NO DATA","E78.5","F41.9","Z79.84","Z87.891","F41.1","D64.9","Z11.59","Z20.828","H40.013","E66.9","R09.02","M25.572","Z79.899","M25.562"],"date":["2021-01-12","2021-04-13","2021-04-13","2021-04-13","2021-01-26","2019-01-23","2019-01-23","2021-01-11","2021-04-13","2021-01-18","2021-01-18","2021-01-18","2021-01-07","2021-01-11","2020-12-12","2021-04-13","2021-01-12","2021-01-12","2022-01-10","2022-01-10","2021-04-13","2021-04-13","2021-04-13","2021-10-07","2021-04-28","2021-01-12","2021-01-18","2022-01-10","2022-01-10","2022-01-10"],"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":[["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","30","Select","Select",""],["","","AMLODIPINE"," AMLODIPINE ","30","Select","Select",""],["","51224010750","METFORMIN","TAB 750MG ER","90","Select","Select",""],["","59762033302","LATANOPROST","SOL 0.00005","2","Select","Select",""],["","","FEROSUL","TAB 325MG","","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","3","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","00904671960","ACETAMINOPHE","TAB 325MG","30","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","28","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","21","Select","Select",""],["","63824000832","MUCINEX","TAB 600MG ER","6","Select","Select",""],["","00363010412","PAIN","TAB 325MG","30","Select","Select",""],["","65862001205","SERTRALINE","TAB 50MG","30","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","60505014102","GLIPIZIDE","TAB 5MG","30","Select","Select",""],["","10702002601","PHENTERMINE","CAP 15MG","30","Select","Select",""],["","","IBUPROFEN","TAB 600MG","","Select","Select",""],["","","BUT\/APAP\/CAF","CAP ","","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}