{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRANDI HARRELL","gend":1,"add":"2000 DARDEN TERRACE","city":"PORTSMOUTH","state":"VA","zip":"23701-9998","dob":"1991-10-28","age":"","mstatus":"","insh":"2078766*01","cliId":"","pno":"757\/274-5335","cno":"","email":"","ename":"","eno":"","pphy":"SMITH, MARGO NP","ppno":"757\/738-1600","pcpadd":"2613 TAYLOR RD SUITE 201","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":"23321","pcpcounty":"","pcpid":"","pcpname":"BON SECOURS WESTERN BRANCH PRIMARY CARE","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/465-8616","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.9","M54.89","F31.60","F12.21","F43.10","F11.21","M54.9","R53.83","F51.09","F17.200","Z30.430","Z23.","F98.8","Z68.26","F32.2","F41.9","Z34.92","Z36.1","F43.20","Z3A.01","Z34.90","H66.001","J06.9","Z68.29","Z01.818","F13.239","F14.23","F31.4","V62.84","F12.20","F13.24","F14.24","F12.288","M54.5","G47.00","F17.210","F43.12","NO DATA","F60.3","O35.8XX0","Z14.8","Z3A.12"],"date":["2021-07-22","2021-11-29","2021-01-07","2021-11-24","2021-11-24","2021-11-24","2020-04-16","2020-04-16","2020-04-16","2020-04-16","2020-10-21","2021-11-17","2020-11-03","2020-11-03","2021-01-12","2021-01-12","2021-11-17","2021-11-17","2021-03-09","2021-09-07","2021-09-07","2020-02-29","2020-02-29","2021-01-12","2021-04-27","2020-04-15","2020-04-15","2020-04-15","2020-04-15","2021-04-06","2020-04-15","2020-04-15","2020-04-15","2020-04-15","2020-04-15","2020-04-15","2021-04-06","2021-04-06","2021-04-06","2021-10-25","2021-10-25","2021-10-25"],"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":[["","16714062701","LAMOTRIGINE","TAB 300MG ER","30","Select","Select",""],["","42806034909","BUPROPN","TAB 300MG XL","30","Select","Select",""],["","00603548321","PROPRANOLOL","TAB 20MG","60","Select","Select",""],["","43547029010","BUPROPION","TAB 200MG SR","60","Select","Select",""],["","49884030702","CLONAZEP","TAB 0.25MG","30","Select","Select",""],["","63402030630","LATUDA","TAB 60MG","30","Select","Select",""],["","16714061205","SERTRALINE","TAB 50MG","45","Select","Select",""],["","47335090218","QUETIAPINE","TAB 25MG","30","Select","Select",""],["","00185067405","HYDROXYZ","CAP 25MG","90","Select","Select",""],["","16714049602","CLOTRIM\/BETA","CRE 1-0.05%","45","Select","Select",""],["","16714075701","ATOMOXETINE","CAP 25MG","30","Select","Select",""],["","62559016601","REGLAN","TAB 10MG","60","Select","Select",""],["","00093220305","METOCLOPRAM","TAB 10MG","60","Select","Select",""],["","23155065201","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","57237004290","VALACYCLOVIR","TAB 500MG","10","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":""}]}]}