{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARGARET   M FURR","gend":1,"add":"6126 STUDELEY AVE","city":"NORFOLK","state":"VA","zip":"23508-9998","dob":"1992-05-06","age":"","mstatus":"","insh":"20066027*01","cliId":"","pno":"757\/374-3566","cno":"757\/374-3566","email":"","ename":"","eno":"","pphy":"SMITH, NICHOLAS MD","ppno":"757\/278-2240","pcpadd":"155 KINGSLEY LANE STE 400","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23505,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/489-6469","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.64","U07.1","F31.9","R53.1","S09.90XA","S01.01XA","R55.","S39.92XA","H11.30","H11.32","F43.10","F41.9"],"date":["2020-06-03","2021-05-06","2021-05-06","2021-07-01","2021-07-01","2021-07-01","2021-07-01","2021-07-01","2020-06-03","2020-06-03","2021-05-06","2021-05-06"],"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":[["","50458056201","INVEGA","INJ 117\/0.75","1","Select","Select",""],["","00781183120","AMOX\/K","TAB 500-125","20","Select","Select",""],["","00143993905","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","43975035003","PALIPERIDONE","TAB ER 3MG","5","Select","Select",""],["","68382080510","TRAZODONE","TAB 50MG","4","Select","Select",""],["","69315013701","BENZTROPINE","TAB 1MG","13","Select","Select",""],["","60505311308","OLANZAPINE","TAB 10MG","20","Select","Select",""],["","00904674759","IBUPROFEN","TAB 200MG","60","Select","Select",""],["","60505267408","ARIPIPRAZOLE","TAB 10MG","4","Select","Select",""],["","00187540004","JUBLIA","SOL 0.1","4","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","12","Select","Select",""],["","00713031788","CICLOPIROX","SOL 0.08","7","Select","Select",""],["","42808011006","SOD","LIQ 10-5%","170","Select","Select",""],["","57237000630","FLUCONAZOLE","TAB 200MG","20","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","44523061701","UREA","CRE 0.4","28","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":""}]}]}