{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ALIYHA   B ALLEN","gend":1,"add":"4032 MIDLOT HIAN TPKE APT 101","city":"RICHMOND","state":"VA","zip":"23224-9998","dob":"2001-08-08","age":"","mstatus":"","insh":"2302560*01","cliId":"","pno":"804\/926-1007","cno":"","email":"","ename":"","eno":"","pphy":"LUCAS, JERRY MD","ppno":"804\/231-6961","pcpadd":"101 COWARDIN AVE","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23224,"pcpcounty":"","pcpid":"","pcpname":"JOHN RANDOLPH OB GYN LLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/231-2241","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.2","Z3A.30","Z11.3","Z36.85","Z3A.38","Z20.828","R10.0","Z3A.12","N61.1","O91.111","F17.200","O99.331","Z3A.13","Z36.0","E55.9","R39.89","Z3A.23","H57.9","N91.2","O26.893","R10.10","M54.6","O21.2","Z3A.35","F33.1","J35.8","E86.0","N92.6","Z3A.32","Z3A.39","R11.2","R10.9","R10.84","O26.92","Z3A.25","O80.","Z37.0","O99.824","O69.81X0","O77.0","NO DATA","M54.9","O99.891","O26.899"],"date":["2021-10-25","2021-03-31","2021-05-27","2021-05-27","2021-05-27","2021-12-21","2020-10-22","2020-11-24","2020-11-24","2020-11-25","2020-11-24","2020-11-24","2020-12-02","2020-12-02","2020-12-02","2020-12-02","2021-02-08","2020-06-24","2020-08-06","2021-06-01","2021-02-27","2021-02-27","2021-02-27","2021-02-27","2020-08-25","2020-09-12","2020-09-12","2020-11-04","2021-04-14","2021-06-06","2021-06-01","2021-06-01","2021-02-27","2021-02-27","2021-02-27","2021-06-06","2021-06-06","2021-06-06","2021-06-06","2021-06-06","2020-06-24","2021-02-27","2021-02-27","2021-02-27"],"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":{"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":[["","","AZITHROMYCIN","TAB 500MG","","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","","CVS","CAP 1000UNIT","","Select","Select",""],["","","CLINDAMYCIN","CAP 300MG","","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":""}]}]}