{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"FAYE ROANE","gend":1,"add":"419 DUNNING ST RM 28","city":"WILLIAMSBURG","state":"VA","zip":"23185-9998","dob":"1968-02-03","age":"","mstatus":"","insh":"20049376*01","cliId":"","pno":"757\/243-3744","cno":"","email":"","ename":"","eno":"","pphy":"WINTHROP, ELIZABETH NP","ppno":"804\/828-6163","pcpadd":"1200 E BROAD STREET","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23298,"pcpcounty":"","pcpid":"","pcpname":"MCV ASSOCIATED PHYSICIANS","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/828-2338","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I63.9","R09.89","F10.29","I10.","F14.10","Z21.","N39.0","B96.20","I69.391","R13.10","I69.398","R26.81","R53.1","R47.81","G31.84","G81.91","G83.14","R47.1","F32.9","M25.70","F19.10","E66.01","Z79.82","R29.810","F10.10","E78.5","B20.","I49.3","J44.9","F17.210","Z86.73","Z79.899","J45.909","K21.9","E55.9","Z66.","G81.01","R19.7","E87.6","I65.21","E11.9","Z86.79","R58.","J06.9","I69.359","Z72.89","R04.0","I51.7","Z78.9","G45.9","R47.02","I63.40","I69.351","R71.0","I42.0","V72.85","F10.20","I67.2","R29.6","R07.9","R06.02","I34.0","I45.81","R94.31","R06.09","M79.645","D69.6","R40.4","R41.0","I82.409","W19.XXXA","L03.115","M79.604","R52.","R79.89","Z88.0"],"date":["2021-09-24","2021-08-21","2021-08-21","2022-05-30","2021-09-24","2021-09-24","2021-08-21","2021-08-21","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2022-05-30","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2021-09-24","2021-09-22","2021-09-22","2021-09-22","2022-05-30","2022-05-30","2022-05-30","2021-09-24","2021-09-24","2022-05-30","2020-02-26","2020-09-14","2022-05-30","2022-05-30","2022-05-30","2020-06-22","2021-09-22","2021-04-02","2021-09-22","2021-08-15","2021-08-15","2022-02-18","2021-08-15","2021-08-15","2020-04-01","2020-06-05","2021-04-02","2021-09-22","2021-09-22","2020-06-05","2021-08-16","2021-08-18","2021-09-22","2021-09-22","2021-09-23","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2019-03-11","2022-05-30","2019-04-19","2019-07-25","2022-02-19","2019-07-25","2019-07-25","2019-01-24","2022-02-18","2022-02-18","2022-05-30","2022-02-18","2022-05-30","2022-05-30","2022-05-30","2022-05-30","2022-05-30"],"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":[["","65862042001","SMZ\/TMP","TAB 800-160","12","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","","AMLODIPINE","TAB 10MG","","Select","Select",""],["","","SMZ-TMP","TAB 400-80MG","","Select","Select",""],["","","SM","TAB 81MG EC","","Select","Select",""],["","00904054460","VITAMIN","TAB 100MG","30","Select","Select",""],["","","BIKTARVY","TAB ","","Select","Select",""],["","64980030301","CHLORTHALID","TAB 25MG","30","Select","Select",""],["","65862035705","CLOPIDOGREL","TAB 75MG","21","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","60","Select","Select",""],["","","ATORVASTATIN","TAB 40MG","","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","11845005651","B-1","TAB 100MG","30","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","10135068962","ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","43598044774","NICOTINE","DIS 14MG\/24H","28","Select","Select",""],["","69097085605","FOSINOPRIL","TAB 10MG","30","Select","Select",""],["","","VENTOLIN","AER ","","Select","Select",""],["","62175061746","PANTOPRAZOLE","TAB 40MG","12","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","61958190101","GENVOYA","TAB ","30","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}