{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JORDAN GUNTER","gend":1,"add":"4233 LLEWELLYN AVE APT 206","city":"NORFOLK","state":"VA","zip":"23504-9998","dob":"1998-09-24","age":"","mstatus":"","insh":"20070161*01","cliId":"","pno":"757\/327-2962","cno":"757\/327-2962","email":"","ename":"","eno":"","pphy":"JAFRI, NAVED MD","ppno":"757\/722-7401","pcpadd":"2117 HARTFORD RD","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":23666,"pcpcounty":"","pcpid":"","pcpname":"MAWC - Obstetrics and Gynecology Associates of Hampton","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/722-7404","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R30.0","N76.0","R42.","W19.XXXA","V62.84","F25.1","F10.129","R44.0","F20.9","F14.10","F25.0","F14.20","F20.81","Z91.14","F17.210","Z88.0","Z20.822","R44.1","R45.851","F19.959","R53.81","Z32.01","O99.331","O99.341","NO DATA","Z79.899","Z3A.00","Z32.00","O36.8310","O26.891","R10.9","Z3A.01","F41.9","Z20.828","Z11.3","Z01.419","Z12.4","Z12.39","J01.00","Z32.02","Z72.0","R10.2","Z3A.14","B34.9","U07.1","R11.2","R06.02","F41.1","O99.891","Z04.89","Z3A.24","O99.342","F31.9","Z67.41","J06.9","R00.0","F14.90","N30.00","R53.83","R19.7","R41.82","O26.893","R11.0","O99.343","Z3A.28"],"date":["2021-01-19","2021-01-19","2021-06-23","2021-06-23","2021-07-24","2022-06-01","2021-06-23","2021-07-20","2022-11-08","2021-06-25","2021-07-24","2021-08-16","2021-06-25","2021-06-25","2022-05-30","2022-11-08","2021-09-10","2021-06-25","2021-07-20","2021-07-24","2021-08-17","2022-05-30","2022-05-30","2022-05-30","2022-05-30","2022-11-08","2022-06-13","2022-05-30","2022-06-13","2022-06-13","2022-06-13","2022-06-13","2022-10-14","2021-10-12","2020-12-17","2021-06-21","2021-06-21","2021-06-21","2021-10-12","2021-10-12","2021-10-12","2022-06-13","2022-06-12","2021-03-11","2021-10-25","2021-10-25","2021-10-25","2022-01-10","2022-06-13","2022-10-14","2022-10-14","2022-10-14","2022-11-08","2022-11-08","2021-05-11","2022-01-10","2021-02-06","2021-05-19","2021-05-19","2021-05-19","2021-07-20","2022-11-08","2022-11-08","2022-11-08","2022-11-08"],"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":[["","39328010610","PRENATAL","TAB 27-1MG","30","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","28","Select","Select",""],["","59267102501","PFIZER","INJ ADLT RTU","0","Select","Select",""],["","45802013970","METRONIDAZOL","GEL 0.75%VAG","70","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","65862001205","SERTRALINE","TAB 50MG","30","Select","Select",""],["","69097082707","BENZTROPINE","TAB 1MG","30","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","30","Select","Select",""],["","65162074510","PROMETHAZINE","TAB 12.5MG","12","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","10","Select","Select",""],["","43547034206","RISPERIDONE","TAB 2MG","14","Select","Select",""],["","65162019010","NAPROXEN","TAB 500MG","20","Select","Select",""],["","65862064169","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","6","Select","Select",""],["","27241005203","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","67877021520","CEFUROXIME","TAB 250MG","14","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":""}]}]}