{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TREMAINE   L WASHINGTON","gend":0,"add":"12 WOODLAND ST","city":"PORTSMOUTH","state":"VA","zip":"23702-9998","dob":"1995-10-16","age":"","mstatus":"","insh":"20053930*01","cliId":"","pno":"412\/812-9531","cno":"","email":"","ename":"","eno":"","pphy":"MARKOVIC, VLADIMIR MD","ppno":"757\/393-6363","pcpadd":"3415 GRANBY STREET","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23504,"pcpcounty":"","pcpid":"","pcpname":"Hampton Roads Community Health Center","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/397-0047","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F20.9","F20.0","M79.646","F23.","Z11.59","F29.","R46.2","F25.0","F20.3","R45.4","Z20.828","R45.1","R45.6","S60.511A","Z03.818","V62.84","R94.31","F32.0","Z04.6","L90.5","Z79.899","F12.20","F41.9","Z91.19","Z78.1","R53.83","Z91.14","V58.69","V62.85","F17.210","L70.9","R03.0","Z72.0","Z77.22","L70.0","F17.200"],"date":["2021-12-13","2021-12-04","2020-11-06","2020-11-07","2020-11-07","2021-03-30","2021-11-28","2021-12-06","2021-12-05","2021-06-20","2020-11-07","2020-12-27","2020-12-27","2020-12-27","2021-03-21","2021-03-21","2021-03-29","2021-08-06","2019-01-04","2019-01-04","2019-11-22","2019-01-08","2019-11-22","2019-11-12","2019-11-12","2019-11-23","2019-11-25","2019-11-25","2019-11-25","2019-11-25","2019-11-25","2019-01-09","2019-04-10","2019-04-10","2019-11-23","2019-11-23"],"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":[["","50111043301","TRAZODONE","TAB 50MG","30","Select","Select",""],["","50458056301","INVEGA","INJ 156MG\/ML","1","Select","Select",""],["","00603243821","BENZTROPINE","TAB 1MG","30","Select","Select",""],["","33342008507","OLANZAPINE","TAB 15MG ODT","28","Select","Select",""],["","43547034206","RISPERIDONE","TAB 2MG","7","Select","Select",""],["","51079073320","HALOPERIDOL","TAB 0.5MG","14","Select","Select",""],["","67457038158","HALOPER","INJ 100MG\/ML","5","Select","Select",""],["","63402030230","LATUDA","TAB 20MG","30","Select","Select",""],["","43547030303","ARIPIPRAZOLE","TAB 5MG","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":[]}},{"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":""}]}]}