{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARIAN   J HARRINGTON","gend":1,"add":"1890 GREEN LEAF DR APT 1","city":"NORFOLK","state":"VA","zip":"23523-9998","dob":"1997-07-15","age":"","mstatus":"","insh":"3882322*01","cliId":"","pno":"240\/350-2875","cno":"","email":"","ename":"","eno":"","pphy":"MOORE, ANDREW W MD","ppno":"757\/446-7979","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\/446-8907","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S46.911A","A59.9","N76.0","B37.9","Z32.01","O20.8","Z3A.01","R31.9","L73.8","R10.32","Z33.1","R10.2","R58.","I10.","E66.9","Z87.891","Z68.31","R11.2","J03.90","O21.9","R10.9","O41.8X10","O46.8X1","O98.82","O10.92","Z37.0","O99.214","A59.01","O99.02","O69.81X0","Z23.","Z79.82","Z87.59","Z3A.39","Z82.5","Z83.3","Z82.49","Z79.899","Z01.818","Z01.419","Z11.3","Z30.9","Z32.02","O80.","W01.0XXA"],"date":["2020-01-31","2020-03-03","2020-03-03","2020-03-03","2020-03-03","2021-12-19","2021-12-19","2021-12-19","2019-09-13","2021-12-19","2021-12-19","2021-12-19","2021-12-19","2021-12-19","2021-12-19","2021-12-19","2021-12-19","2021-12-19","2019-08-28","2020-03-16","2020-03-16","2020-03-16","2020-03-16","2020-10-31","2020-10-31","2020-10-31","2020-10-31","2020-10-31","2020-10-31","2020-10-31","2021-04-20","2020-10-31","2020-10-31","2020-10-31","2020-10-31","2020-10-31","2020-10-31","2020-10-31","2020-10-31","2021-04-20","2021-04-20","2021-04-20","2021-04-20","2020-10-31","2020-01-31"],"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":[["","","NAPROXEN"," NAPROXEN ","20","Select","Select",""],["","","AMOXICILLIN"," AMOXICILLIN ","20","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","","VITAMIN","CAP 50000UNT","","Select","Select",""],["","","CLINDAMYCIN","CAP 300MG","","Select","Select",""],["","","FERROUS","TAB 325MG","","Select","Select",""],["","","IRON","TAB 325MG","","Select","Select",""],["","","DOK","CAP 100MG","","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","Select","Select",""],["","","DOCUSATE","CAP 100MG","","Select","Select",""],["","","FEROSUL","TAB 325MG","","Select","Select",""],["","","FAMOTIDINE","TAB 20MG","","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":""}]}]}