{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EVELYN OGLESBY","gend":1,"add":"2711 LEO ST APT 4","city":"NORFOLK","state":"VA","zip":"23504-9998","dob":"1985-11-09","age":"","mstatus":"","insh":"2074523*01","cliId":"","pno":"347\/475-5057","cno":"","email":"","ename":"","eno":"","pphy":"MCDERMOTT, MARIE NP","ppno":"757\/278-2240","pcpadd":"155 KINGSLEY LANE 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":["Z39.1","F43.22","Z63.0","O26.90","R12.","K21.9","R59.9","V23.9","Z01.419","NO DATA","N76.0","Z30.40","R03.0","Z73.3","O47.1","Z3A.38","R23.2","B37.3","Z34.81","Z3A.16","N76.4","O26.92","N90.9","Z3A.27","O99.810","F43.20","Z34.83","Z3A.36","Z36.85","Z23.","Z33.1","O42.92","Z3A.39","Z37.0","O77.0","O69.1XX0","Z39.2","Z30.09","L98.9","Z13.32","Z30.41","Z32.02","H18.892","Z20.828","O80.","Z01.411","L03.90","L65.9","Z71.9","M65.4"],"date":["2019-07-24","2019-11-07","2019-11-07","2019-09-30","2021-05-18","2021-12-30","2021-12-30","2019-08-19","2021-08-03","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2019-09-24","2019-09-24","2021-05-18","2021-05-18","2019-04-22","2019-04-22","2019-04-22","2019-07-08","2019-07-08","2019-07-08","2019-07-08","2019-08-01","2019-09-09","2019-09-09","2019-09-09","2019-09-09","2019-09-09","2019-09-30","2019-09-30","2019-09-30","2019-09-30","2019-09-30","2019-11-20","2020-05-26","2019-11-20","2019-11-20","2020-11-30","2020-11-30","2021-03-18","2021-10-29","2019-09-30","2020-05-26","2020-05-26","2020-07-15","2020-07-15","2019-03-20"],"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":[]},{"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":""}]}]}