{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DARNEISHA   E EMBRY","gend":1,"add":"7228 CHESAPEAKE BLVD APT 5","city":"NORFOLK","state":"VA","zip":"23513-9998","dob":"2003-10-09","age":"","mstatus":"","insh":"2068993*01","cliId":"","pno":"757\/324-4809","cno":"","email":"","ename":"","eno":"","pphy":"CAHILL, BETHANY L NP","ppno":"757\/278-2240","pcpadd":"155 KINGSLEY LN STE 400","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23505,"pcpcounty":"","pcpid":"","pcpname":"DEPAUL MEDICAL ASSOCIATES","plan":"OHP","program":"MEDICAID","lob":"M4","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":["F90.2","T50.901A","T39.1X2A","T50.992A","K59.09","F91.3","Z91.5","Z20.828","S82.831B","R10.2","N92.6","R31.9","Z11.3","N89.8","Z32.02","A59.9","R10.84","N30.00","Z01.411","Z30.09","Z51.89","H10.022","R30.0","Z68.52","Z30.015","N92.5","T39.1X1A","F31.89","F32.2","V62.84","R10.11","K59.00","N64.4","Z13.31","R10.33","R10.13","S93.602A","S93.402A","Z30.40","Z30.42","R11.2","R53.83","F33.9","N73.9","J02.9","S13.4XXA","V58.89","Z79.2"],"date":["2021-12-26","2020-01-12","2020-01-13","2020-01-13","2020-01-13","2020-01-13","2020-01-13","2021-01-05","2021-06-01","2021-12-17","2021-09-21","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-09-21","2020-08-01","2019-03-13","2021-12-17","2021-05-17","2021-05-29","2021-01-12","2021-01-12","2021-01-12","2021-05-17","2020-12-23","2020-01-13","2020-01-14","2020-01-16","2020-01-14","2020-03-09","2020-08-01","2020-03-09","2019-09-19","2019-09-19","2020-01-13","2020-05-15","2020-05-15","2021-09-21","2019-01-11","2020-01-13","2020-01-13","2020-01-14","2020-11-10","2020-02-05","2020-09-04","2021-05-29","2021-05-29"],"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":[["","","XULANE"," XULANE ","3","Select","Select",""],["","","CEPHALEXIN"," CEPHALEXIN ","14","Select","Select",""],["","","DOCUSATE"," DOCUSATE ","60","Select","Select",""],["","","BISACODYL"," BISACODYL ","6","Select","Select",""],["","","CVS"," CVS ","510","Select","Select",""],["","","JUNEL","TAB 43831","","Select","Select",""],["","","ONDANSETRON","TAB 4MG","","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","","PANTOPRAZOLE","TAB 20MG","","Select","Select",""],["","","POLYETH","POW 3350 NF","","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","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":""}]}]}