{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANTHONY   L BROWN","gend":0,"add":"3432 VIRGINIA BEACH BLVD RM 153","city":"VIRGINIA BEACH","state":"VA","zip":"23452-9998","dob":"2004-08-16","age":"","mstatus":"","insh":"2120883*01","cliId":"","pno":"757\/489-3313","cno":"","email":"","ename":"","eno":"","pphy":"CURRY, MICHELLE T MD","ppno":"757\/547-5851","pcpadd":"513 BAYLOR","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23320,"pcpcounty":"","pcpid":"","pcpname":"M.T. Curry Inc.","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/548-0734","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["V62.84","Z20.822","M85.88","V54.19","Z79.899","NO DATA","S02.600A","S02.609A","S01.83XA","W34.00XA","S02.609B","S93.601A","S99.929A","S02.66XB","S02.601B","S02.602B","F43.8","S02.66XA","Z00.8","R44.3","Z98.890","Z48.89","F32.1","V62.85","T78.40XA","R21.","T14.91XA"],"date":["2022-02-03","2022-02-03","2021-12-10","2021-12-10","2021-12-10","2021-12-29","2021-07-02","2021-07-03","2021-07-03","2021-07-03","2021-07-02","2021-06-24","2021-06-24","2021-07-02","2021-07-02","2021-07-02","2021-10-13","2021-12-10","2021-12-22","2021-12-22","2021-12-22","2021-12-22","2021-12-19","2021-12-19","2019-10-21","2019-10-21","2022-02-03"],"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":[["","70954002010","PRAZOSIN","CAP 2MG","30","Select","Select",""],["","30768015745","MELATONIN","TAB 5MG","30","Select","Select",""],["","43598096730","ARIPIPRAZOLE","TAB 10MG","30","Select","Select",""],["","16729016917","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","14539067501","HYDROXYZ","CAP 50MG","20","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","57896045806","SENNA","TAB 8.6-50MG","60","Select","Select",""],["","59651003247","IBUPROFEN","SUS 100\/5ML","473","Select","Select",""],["","54838014440","CHLD","LIQ 160\/5ML","472","Select","Select",""],["","66689040316","OXYCODONE","SOL 5MG\/5ML","15","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","45802086866","POLYETH","POW 3350 NF","11","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","59762001601","CLINDAMYCIN","SOL 75MG\/5ML","800","Select","Select",""],["","00904530660","BANOPHEN","CAP 25MG","25","Select","Select",""],["","00054001825","PREDNISONE","TAB 20MG","8","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":""}]}]}