{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"APRIL   D TAYLOR","gend":1,"add":"759 LINCOLN ST","city":"NORFOLK","state":"VA","zip":"23510-9998","dob":"1970-07-06","age":"","mstatus":"","insh":"2157201*01","cliId":"","pno":"757\/597-4570","cno":"757\/597-4570","email":"","ename":"","eno":"","pphy":"BARAKOTI, PRASHANT MD","ppno":"757\/627-6220","pcpadd":"STE 100 400 W BRAMBLETON AVE","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23510,"pcpcounty":"","pcpid":"","pcpname":"VA Beach Internal Medicine","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/627-0200","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25.531","M65.4","M65.311","R61.","M77.9","G43.909","Z87.891","Z04.9","N92.6","Z11.4","U07.1","M25.512","R51.9","Z56.6","R53.81","S93.401A","Z20.822","R21.","Z11.3","M25.562"],"date":["2020-01-30","2020-01-30","2020-01-30","2020-01-03","2020-01-03","2020-01-03","2020-01-03","2020-12-17","2020-12-21","2020-12-21","2022-01-11","2022-01-11","2022-01-11","2022-01-11","2022-01-11","2022-09-29","2021-01-25","2021-01-25","2021-01-25","2020-10-27"],"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":[["","10939057133","HYDROCORT","OIN 0.005","57","Select","Select",""],["","51672201002","HC\/ALOE","CRE 0.005","57","Select","Select",""],["","00378427593","VALACYCLOVIR","TAB 500MG","30","Select","Select",""],["","11822547890","VITAMIN","CAP 2000UNIT","90","Select","Select",""],["","16729017301","AMITRIPTYLIN","TAB 50MG","45","Select","Select",""],["","16714079701","SUMATRIPTAN","TAB 50MG","18","Select","Select",""],["","59762453802","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","68382005101","MELOXICAM","TAB 15MG","30","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":""}]}]}