{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MAYA   T DUNSTON","gend":1,"add":"433 W 28TH ST APT B","city":"NORFOLK","state":"VA","zip":"23508-9998","dob":"1997-11-21","age":"","mstatus":"","insh":"4096592*01","cliId":"","pno":"757\/304-8539","cno":"757\/304-8539","email":"","ename":"","eno":"","pphy":"MOAN, ASHLEY D NP","ppno":"757\/481-7222","pcpadd":"1080 FIRST COLONIAL RD STE 300","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23454,"pcpcounty":"","pcpid":"","pcpname":"MAWC - Complete Women's Care","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/390-2935","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O75.89","Z37.0","R03.0","E66.9","O99.214","O99.02","D64.9","Z3A.38","Z11.59","Z79.899","Z91.048","O86.4","N30.00","K04.01","K08.89","O99.013","O60.03","O28.1","O99.213","Z3A.33","Z23.","Z34.93","O20.8","Z3A.10","O80.","Z11.3","Z30.9","D56.3","Z20.822","Z86.16","O86.22","U07.1","O98.53","Z16.11","B96.20","Z87.891","Z88.8","Z82.49","R68.83","Z20.828","N39.0","Z39.2","K04.7","K02.9","O76.","Z3A.36","V23.41","L20.84","O20.0","Z3A.00","Z01.419","Z30.40","Z36.9","Z3A.26","Z33.1"],"date":["2020-07-28","2020-07-28","2020-07-28","2020-07-28","2020-07-28","2020-07-28","2022-08-23","2020-07-28","2020-07-28","2022-09-11","2021-11-12","2020-08-12","2020-08-04","2021-09-20","2021-11-05","2022-09-11","2022-09-13","2022-09-13","2022-09-13","2022-09-13","2022-07-26","2020-07-15","2020-01-11","2020-01-11","2020-07-28","2020-10-05","2020-10-05","2022-09-11","2022-09-11","2022-09-11","2020-08-04","2020-08-04","2020-08-04","2020-08-04","2020-08-04","2020-08-04","2020-08-04","2020-08-04","2020-08-03","2020-08-03","2020-08-12","2020-08-15","2021-11-12","2021-11-05","2020-06-15","2020-07-15","2022-08-23","2022-08-31","2020-01-11","2020-01-11","2021-10-04","2021-10-04","2022-07-26","2022-07-26","2020-01-28"],"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":[]},{"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":[["","00536408501","PRENATAL","TAB 28-0.8MG","90","Select","Select",""],["","45802005505","TRIAMCINOLON","OIN 0.001","454","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","30","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","57237004105","PENICILLN","TAB 500MG","28","Select","Select",""],["","00555902658","JUNEL","TAB 43831","28","Select","Select",""],["","65862018501","CLINDAMYCIN","CAP 150MG","56","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","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":""}]}]}