{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MERANDA HARRIS","gend":1,"add":"4213 CEDAR LN APT 7","city":"PORTSMOUTH","state":"VA","zip":"23703-9998","dob":"1992-08-31","age":"","mstatus":"","insh":"1655508*01","cliId":"","pno":"757\/602-6637","cno":"757\/602-6637","email":"","ename":"","eno":"","pphy":"ADKINS, WILLIAM MD","ppno":"757\/539-0251","pcpadd":"2000 MEADE PKWY","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23434,"pcpcounty":"","pcpid":"","pcpname":"Lakeview OB\/GYN Meade","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/483-7160","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S36.113A","K66.1","K83.9","K83.8","Z48.89","K72.90","Z30.09","S36.119A","K75.0","S36.116A","D57.3","Z83.3","Z82.49","V58.89","K83.2","T85.590A","Z46.59","J02.9","Z01.419","Z46.82","L02.219","L03.319","L03.313","K91.89","R52.","R10.32","R10.11","R06.02","T88.9XXA","R50.9","Z16.11","R51.","R00.0","Z11.3","R57.8","S22.31XA","D62.","E87.1","D69.6","I10.","S81.012A","E83.39","S81.811A","D72.829","V72.85","S35.299A","B95.4","B96.89","Z30.42","J69.0","A41.9","Z01.818","Z01.812","M79.89","J96.00","S81.011A"],"date":["2020-03-02","2020-02-29","2020-05-01","2020-03-06","2020-03-05","2020-05-02","2020-09-03","2020-03-13","2020-05-03","2020-05-03","2020-05-01","2020-05-01","2020-05-01","2020-05-01","2020-06-04","2020-06-04","2020-06-04","2021-09-19","2022-01-13","2020-03-13","2020-06-13","2020-06-13","2020-06-13","2020-03-05","2020-04-11","2020-03-12","2020-04-11","2020-03-13","2020-03-13","2020-05-01","2020-04-12","2020-04-12","2020-05-01","2020-02-13","2020-02-28","2020-02-28","2020-02-28","2020-02-28","2020-02-28","2020-02-28","2020-02-28","2020-02-28","2020-02-28","2020-02-28","2020-02-28","2020-02-28","2020-03-13","2020-03-13","2020-09-24","2020-03-12","2020-03-12","2020-06-02","2020-06-02","2020-02-28","2020-02-28","2020-02-28"],"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":[]},{"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":[["","45802026337","CLINDAMYCIN","MIS 0.01","60","Select","Select",""],["","57237002901","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","10702001850","OXYCODONE","TAB 5MG","10","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","16714049401","AMOX\/K","TAB 500-125","14","Select","Select",""],["","16714065202","CIPROFLOXACN","TAB 500MG","28","Select","Select",""],["","69238110005","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","68462019001","NAPROXEN","TAB 500MG","20","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","42858010301","OXYCOD\/APAP","TAB 7.5-325","8","Select","Select",""],["","65162074510","PROMETHAZINE","TAB 12.5MG","10","Select","Select",""],["","00378334053","XULANE","DIS 150-35","3","Select","Select",""],["","51672139509","TRETINOIN","CRE 0.001","45","Select","Select",""],["","00187516445","RETIN-A","CRE 0.001","45","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":""}]}]}