{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KRISTINA DAVIS","gend":1,"add":"PO BOX 711","city":"LANCASTER","state":"VA","zip":"22503-9998","dob":"1986-07-02","age":"","mstatus":"","insh":"2214951*01","cliId":"","pno":"804\/567-0613","cno":"","email":"","ename":"","eno":"","pphy":"VOGEL, MATTHEW MD","ppno":"804\/288-4084","pcpadd":"102 DMV DRIVE","pcpcity":"KILMARNOCK","pcpstate":"VA","pcpzip":22482,"pcpcounty":"","pcpid":"","pcpname":"Virginia Women's Center","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/433-2392","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O20.9","R76.0","Z3A.09","O03.4","R87.612","N96.","Z32.02","Z23.","Z3A.28","O02.1","Z34.01","Z3A.01","Z39.1","Z34.82","Z34.83","R00.2","Z3A.12","I34.0","I07.0","I37.1","O99.612","Z3A.24","O69.81X0","O99.344","NO DATA","Z20.822","Z37.0","Z3A.39","Z59.41","Z90.49","N39.0","R30.9","N92.5","B37.3","Z32.01","R39.198","G43.001","Z3A.16","O09.522","O99.512","Z3A.20","M54.89","O80.","Z3A.00"],"date":["2021-04-13","2021-07-27","2021-04-13","2020-04-16","2020-05-29","2020-06-11","2020-05-29","2021-08-24","2021-08-24","2020-04-17","2020-02-17","2020-02-17","2021-09-28","2021-09-28","2021-11-09","2021-06-11","2021-05-25","2021-06-11","2021-06-11","2021-06-11","2021-07-27","2021-07-27","2021-11-09","2021-11-09","2021-11-09","2021-11-09","2021-11-10","2021-11-09","2021-11-09","2021-11-09","2020-05-01","2021-03-18","2021-03-18","2021-03-18","2021-03-18","2021-06-01","2021-06-01","2021-06-01","2021-07-02","2021-07-02","2021-07-02","2021-09-23","2021-11-10","2021-11-10"],"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":[["","","PRENATAL","TAB 27-0.8MG","","Select","Select",""],["","","OXYCODONE","TAB 5MG","","Select","Select",""],["","","NITROFURANTN","CAP 100MG","","Select","Select",""],["","","AMOX\/K","TAB 500-125","","Select","Select",""],["","","PROMETHAZINE","TAB 25MG","","Select","Select",""],["","","SMZ\/TMP","TAB 800-160","","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":""}]}]}