{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MIRACLE   K MINES","gend":1,"add":"2708 ROANOKE AVE APT 216","city":"NEWPORT NEWS","state":"VA","zip":"23607-9998","dob":"1999-03-24","age":"","mstatus":"","insh":"20032173*01","cliId":"","pno":"757\/952-7022","cno":"757\/915-2100","email":"","ename":"","eno":"","pphy":"FISHER, DENEISHIA MD","ppno":"757\/223-9794","pcpadd":"SUITE 110 860 OMNI BLVD","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23606,"pcpcounty":"","pcpid":"","pcpname":"TPMG OBGYN AND GYNECOLOGY","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/223-9168","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F20.9","O60.14X0","O32.2XX0","Z3A.33","Z37.0","Z34.83","F25.0","F41.1","Z30.430","Z32.02","N73.0","B96.89","A59.9","D64.9","B37.3","N39.0","Z13.32","Z39.2","Z30.431","Z68.41","F25.9","Z30.09","G89.18","F17.210","Z72.89","F12.90","Z88.8","O60.03","O41.1230","Z3A.31","O40.3XX0","O32.1XX0","F43.10","O47.9","R07.81","M54.5","N93.8","N91.2","N89.9","R35.0","Z12.4","Z01.419","Z11.3","NO DATA"],"date":["2021-03-09","2019-08-23","2019-08-23","2019-08-23","2019-08-23","2019-08-23","2019-12-05","2019-12-05","2019-11-27","2021-08-31","2020-03-07","2020-03-07","2020-03-07","2020-03-07","2020-03-07","2021-08-31","2019-10-08","2019-10-08","2019-12-31","2019-12-31","2019-03-24","2019-11-12","2019-08-24","2021-08-31","2021-08-31","2021-08-31","2021-08-31","2019-08-05","2019-08-05","2019-08-05","2019-08-05","2019-08-23","2019-02-14","2019-08-05","2020-05-31","2020-05-31","2020-05-31","2019-04-10","2019-04-10","2019-04-10","2019-04-10","2021-01-05","2021-01-05","2021-01-05"],"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":[["","","PRENATAL"," PRENATAL ","30","Select","Select",""],["","","FERROUS"," FERROUS ","60","Select","Select",""],["","","IRON"," IRON ","30","Select","Select",""],["","","OXYCOD\/APAP"," OXYCOD\/APAP ","28","Select","Select",""],["","","SERTRALINE"," SERTRALINE ","30","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","60","Select","Select",""],["","","ETODOLAC","CAP 200MG","","Select","Select",""],["","","CYCLOBENZAPR","TAB 5MG","","Select","Select",""],["","","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","","DOXYCYC","TAB 100MG","","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":""}]}]}