{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JODY CARTER","gend":1,"add":"411 FORT WORTH AVE APT 5","city":"NORFOLK","state":"VA","zip":"23505-9998","dob":"1970-05-07","age":"","mstatus":"","insh":"1587583*01","cliId":"","pno":"757\/663-8604","cno":"","email":"","ename":"","eno":"","pphy":"HASAS, PEDRO D MD","ppno":"757\/583-4329","pcpadd":"330 E BAYVIEW BLVD","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23503,"pcpcounty":"","pcpid":"","pcpname":"PEDRO D HASAS MD PLC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/583-1770","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I63.411","I69.354","I69.322","I69.391","M62.81","I63.9","R47.1","R26.81","Z95.828","Z86.718","Z86.73","R29.818","G81.94","I63.511","G93.6","R00.1","D72.829","E78.5","R41.82","G93.41","I95.9","K42.9","I82.402","I10.","Z74.09","M25.512","I69.334","I63.412","K42.0","I61.9","I82.412","I82.432","NO DATA","I82.442","R29.706","T45.615A","R29.810","M10.9","I63.50","G93.5","R51.","Z79.82","I63.441","R13.10","Z92.82","E78.2","S46.012A","I63.311","I05.1","K92.9","R06.00","K44.9","Z79.899","M54.30","E55.9","E66.09","R00.0","M75.22","R94.31","G83.24"],"date":["2020-03-17","2020-09-03","2020-03-14","2020-03-14","2020-06-02","2020-06-02","2020-05-28","2020-04-02","2020-08-20","2020-08-20","2020-08-20","2020-02-07","2020-03-17","2020-02-21","2020-02-20","2020-02-25","2020-02-12","2020-11-03","2020-02-21","2020-02-25","2020-02-25","2020-02-25","2020-07-29","2020-11-03","2020-03-02","2020-11-03","2020-11-03","2020-02-09","2020-02-12","2020-02-07","2020-08-04","2020-02-07","2020-02-07","2020-02-07","2020-02-07","2020-02-07","2020-02-07","2020-03-17","2020-02-07","2020-02-20","2020-02-10","2020-02-25","2020-02-11","2020-03-17","2020-03-17","2020-03-17","2020-08-13","2020-11-03","2020-02-10","2020-02-23","2020-02-17","2020-02-21","2020-02-25","2020-02-25","2020-02-25","2020-02-25","2020-02-26","2020-04-17","2020-02-07","2020-09-03"],"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":[["","45802046611","ECONAZOLE","CRE 0.01","30","Select","Select",""],["","","LEVETIRACETA","TAB 500MG","","Select","Select",""],["","","AMLODIPINE","TAB 5MG","","Select","Select",""],["","","SPIRONOLACT","TAB 25MG","","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","","HYDROCHLOROT","TAB 25MG","","Select","Select",""],["","","CVS","TAB 325MG","","Select","Select",""],["","","ATORVASTATIN","TAB 80MG","","Select","Select",""],["","","LISINOPRIL","TAB 10MG","","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":""}]}]}