{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TELISHA   S WILLIAMS","gend":1,"add":"285 DALE DR APT 203","city":"PORTSMOUTH","state":"VA","zip":"23704-9998","dob":"1990-06-24","age":"","mstatus":"","insh":"2765071*01","cliId":"","pno":"757\/738-8485","cno":"","email":"","ename":"","eno":"","pphy":"DAVIS, STEPHEN MD","ppno":"757\/446-7900","pcpadd":"825 FAIRFAX AVE SUITE 310","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23507,"pcpcounty":"","pcpid":"","pcpname":"EVMS OB\/GYN","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/446-7464","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z39.1","Z34.82","Z34.83","O60.12X0","Z3A.27","Z37.0","M54.89","O80.","Z3A.38","O99.214","E66.01","O99.62","K21.9","O99.89","G44.229","Z87.891","Z79.899","Z36.85","L73.1","NO DATA","O99.324","O21.0","F12.90","O99.344","F41.9","O32.2XX0","Z20.822","Z83.49","Z82.49","Z82.3","Z82.5","O60.14X0","O99.013","O99.213","Z3A.28","Z23.","R10.12","Z33.1","V23.89","Z39.2","Z3A.19","O99.019","Z34.90","F32.9","I44.0","L73.2","Z87.59","Z86.59","Z3A.15","Z3A.35","Z3A.23","O76.","R11.2","R32.","R10.2","S61.210A","S61.212A","R11.11","O26.90","Z48.89","V23.9","Z3A.25","F43.23","Z91.49","Z30.2","Z30.42","Z32.02","O99.345","Z30.09"],"date":["2021-01-27","2021-01-27","2021-01-27","2021-12-02","2021-12-02","2021-12-02","2021-12-09","2021-03-09","2021-03-09","2021-03-08","2021-03-08","2021-12-01","2021-12-01","2019-10-01","2019-10-01","2019-10-01","2021-03-08","2019-10-01","2019-12-26","2022-02-14","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-01","2021-12-02","2020-12-23","2021-02-09","2020-12-23","2021-02-09","2021-08-13","2021-08-13","2019-09-24","2022-01-11","2020-10-23","2021-02-09","2020-10-23","2021-05-12","2021-08-11","2022-07-06","2020-09-22","2022-01-11","2020-09-22","2021-02-09","2021-11-02","2021-03-08","2021-03-08","2021-03-10","2019-10-18","2019-10-27","2019-10-27","2021-08-11","2021-12-01","2022-07-06","2021-11-18","2021-11-18","2022-02-14","2022-02-14","2022-05-31","2022-03-15","2022-03-15","2022-01-11","2022-01-11"],"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":[["","10702000350","PROMETHAZINE","TAB 25MG","60","Select","Select",""],["","68180035202","SERTRALINE","TAB 50MG","30","Select","Select",""],["","38779062905","SODIUM","POW CHLORIDE","28","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","67618010160","COLACE","CAP 100MG","10","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","","CLINDAMYCIN","SOL 0.01","","Select","Select",""],["","","VITAMIN","TAB 50MG","","Select","Select",""],["","13107000130","MIRTAZAPINE","TAB 7.5MG","30","Select","Select",""],["","45802058046","SCOPOLAMINE","DIS 1MG\/3DAY","10","Select","Select",""],["","00904674880","BISACODYL","TAB 5MG EC","20","Select","Select",""],["","","PRENAISSANCE","CAP ","","Select","Select",""],["","80681013800","CALCIUM\/D3","TAB 600MG","60","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","100","Select","Select",""],["","00904645760","DOK","CAP 100MG","60","Select","Select",""],["","11917017654","PRENATAL","CHW 0.4-32.5","90","Select","Select",""],["","00093220310","METOCLOPRAM","TAB 10MG","30","Select","Select",""],["","00378623201","CITALOPRAM","TAB 20MG","30","Select","Select",""],["","10135011901","PYRIDOXINE","TAB 25MG","30","Select","Select",""],["","59779086322","SLEEP-AID","TAB 25MG","30","Select","Select",""],["","12843039324","MILK","SUS 400\/5ML","355","Select","Select",""],["","62175011837","OMEPRAZOLE","CAP 20MG","60","Select","Select",""],["","00904699880","DOCUSATE","CAP 100MG","30","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","90","Select","Select",""],["","","UNISOM","TAB 25MG","","Select","Select",""],["","16500056870","ONE","CHW PRENATAL","60","Select","Select",""],["","","WAL-SOM","TAB 25MG","","Select","Select",""],["","","FERROUS","TAB 325MG","","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":""}]}]}