{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANGELIA JONES-MCNAIR","gend":1,"add":"2116 ROANOKE AVE","city":"NEWPORT NEWS","state":"VA","zip":"23607-9998","dob":"1968-11-18","age":"","mstatus":"","insh":"2243677*01","cliId":"","pno":"757\/814-7669","cno":"","email":"","ename":"","eno":"","pphy":"TOUCHET, BRADLEY J MD","ppno":"757\/594-3800","pcpadd":"10510 JEFFERSON AVENUE STE A","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23601,"pcpcounty":"","pcpid":"","pcpname":"Riverside Brentwood Medical Center","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/594-3818","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K29.00","R10.13","E87.1","K59.00","Q83.1","K42.9","D72.829","J98.4","F41.1","R35.0","F40.240","R39.9","R82.90","R10.9","R06.00","R60.9","J45.20","I49.1","I49.3","I45.89","I35.8","I10.","M25.551","M25.552","E66.01","Z68.42","J45.909","R60.0","M54.5","R03.0","E66.9","D62.","J30.2","M70.61","M70.62","N94.10","N89.8","Z01.419","Z12.31","Z11.4","R59.0","N95.9","R22.31"],"date":["2021-01-12","2021-01-12","2021-01-12","2021-07-14","2020-10-23","2021-01-06","2021-01-06","2021-07-14","2021-07-14","2021-07-14","2021-07-14","2019-12-11","2019-12-11","2021-01-06","2021-05-24","2021-04-22","2021-05-14","2021-05-24","2021-05-24","2021-05-24","2021-04-07","2021-05-17","2021-05-17","2021-05-17","2020-10-23","2020-10-23","2020-10-23","2021-03-29","2021-03-29","2021-03-29","2021-03-29","2021-03-29","2021-04-22","2021-04-22","2021-04-22","2021-08-27","2021-08-27","2021-02-18","2020-01-09","2020-01-09","2020-01-09","2020-01-09","2020-09-24"],"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":[["","16714079904","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","43547028010","ESCITALOPRAM","TAB 5MG","30","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","13107008305","LORAZEPAM","TAB 0.5MG","2","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","30","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","49035030603","EQ","POW ","510","Select","Select",""],["","55111064530","OMEPRAZOLE","CAP 40MG","60","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","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":""}]}]}