{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DOUGLAS   C SMITH","gend":0,"add":"3656 MALIBU PALMS DR APT 201","city":"VIRGINIA BEACH","state":"VA","zip":"23452-9998","dob":"1964-07-01","age":"","mstatus":"","insh":"20069815*01","cliId":"","pno":"","cno":"","email":"","ename":"","eno":"","pphy":"CREAKBAUM, JESSIE M PA","ppno":"757\/686-3508","pcpadd":"1168 FIRST COLONIAL RD STE 201","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23454,"pcpcounty":"","pcpid":"","pcpname":"Va Beach Internal Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/496-3822","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M46.1","M96.1","Z98.1","Z96.89","Z20.828","R07.9","R42.","R11.0","R05.","Z48.89","M54.89","Z01.810","M47.812","M47.22","M47.12","G95.89","L20.82","L28.0","M43.25","M40.05","R29.2","R20.2","R26.89","R53.1","G95.19","R44.9","R26.2","R32.","R15.9","R27.8","M48.02","G95.20","I10.","E78.00","M40.00","K21.9","F17.210","R29.6","Z91.041","Z01.812","Z23.","E78.5","J44.9","M54.5","F17.218","J30.1","L23.5","G89.29","Z68.24"],"date":["2021-09-14","2021-09-14","2021-05-17","2021-01-26","2020-11-30","2020-11-30","2020-11-30","2020-11-30","2020-11-30","2021-05-17","2021-04-09","2021-04-22","2021-05-17","2021-04-28","2021-04-28","2021-04-28","2021-11-12","2021-11-12","2021-04-09","2021-04-09","2021-04-09","2021-04-28","2021-04-09","2021-04-18","2021-04-18","2021-04-18","2021-04-18","2021-04-18","2021-04-18","2021-04-18","2021-04-28","2021-04-28","2021-04-28","2021-04-28","2021-04-28","2021-04-28","2021-04-28","2021-04-28","2021-04-28","2021-04-28","2020-10-16","2020-10-16","2020-10-16","2020-10-16","2020-10-16","2020-10-16","2020-10-16","2020-10-16","2020-10-16"],"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":[["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","","CHANTIX","TAB 1MG","","Select","Select",""],["","","ATORVASTATIN","TAB 40MG","","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","","FAMOTIDINE","TAB 40MG","","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","","TRIAMCINOLON","CRE 0.001","","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":""}]}]}