{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARIA   S ONATE PEREZ","gend":1,"add":"2932 FINCH AVE APT 201","city":"VIRGINIA BEACH","state":"VA","zip":"23453-9998","dob":"1985-11-13","age":"","mstatus":"","insh":"1808868*01","cliId":"","pno":"757\/999-4305","cno":"","email":"","ename":"","eno":"","pphy":"ANYIWO, JOEL O MD","ppno":"757\/689-8430","pcpadd":"1925 GLENN MITCHELL DR STE 100","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23456,"pcpcounty":"","pcpid":"","pcpname":"Princess Anne Medical Associates","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/689-8435","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H69.82","Z11.59","Z03.818","E65.","Z98.890","J02.9","Z20.828","Z01.818","Z12.4","Z20.2","D48.5","L66.8","L08.9","H91.8X3","F33.1","L65.8","H90.42","B35.3","B35.1","M79.672","M79.671","N76.0","Z11.3","Z11.4","E51.8","L63.8","K91.2","L65.9","Z98.84","N92.5","R10.2","E51.9","Z39.2","G43.009","R11.0"],"date":["2020-05-15","2020-07-22","2020-07-22","2020-08-11","2020-08-11","2020-11-17","2021-09-04","2020-07-17","2021-01-07","2021-01-07","2020-05-28","2020-10-22","2020-08-25","2020-09-03","2021-06-24","2020-01-16","2020-05-15","2020-11-06","2020-11-06","2020-11-06","2020-11-06","2021-10-15","2021-10-15","2021-10-15","2020-01-23","2020-08-17","2020-06-18","2020-06-18","2020-06-18","2020-06-19","2020-06-19","2020-01-20","2020-07-16","2019-12-28","2019-12-28"],"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":{"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":[["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","75834002012","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","45802013970","METRONIDAZOL","GEL 0.75%VAG","70","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":""}]}]}