{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAWANA   S JONES-FARRAR","gend":1,"add":"1425 FLOYD ST","city":"PETERSBURG","state":"VA","zip":"23803-9998","dob":"1989-04-16","age":"","mstatus":"","insh":"7603509*01","cliId":"","pno":"804\/921-8257","cno":"","email":"","ename":"","eno":"","pphy":"AKINSANYA, ANUOLUWAPO MD","ppno":"","pcpadd":"4221 CROSSINGS BLVD","pcpcity":"PRINCE GEORGE","pcpstate":"VA","pcpzip":23875,"pcpcounty":"","pcpid":"","pcpname":"SOUTHSIDE PHYSICIANS NETWORK - OB\/GYN","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["NO DATA","Z20.828","N39.46","R35.0","J02.8","B97.89","Z82.49","J02.9","B34.9","R50.9","Z20.822","J01.00","J30.2","R92.8","Z01.419","Z12.31","Z11.3","Z68.20","F32.9","N89.8","N94.6","B00.9","N39.41","Z68.21","Z01.411","D24.1"],"date":["2020-11-16","2021-01-21","2021-03-23","2021-03-23","2022-09-09","2022-09-09","2022-09-09","2022-09-09","2022-07-12","2022-07-12","2022-07-12","2021-05-12","2021-05-12","2020-10-30","2022-08-12","2022-08-12","2022-08-12","2022-08-12","2021-08-11","2021-08-11","2021-08-11","2021-08-11","2021-01-26","2021-01-26","2020-09-28","2020-09-28"],"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":[["","00904688365","ACETAMINOPHE","TAB 650MG ER","15","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","00378427577","VALACYCLOVIR","TAB 500MG","60","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","20","Select","Select",""],["","50580072636","ZYRTEC","TAB 10MG","90","Select","Select",""],["","16571040210","CETIRIZINE","TAB 10MG","90","Select","Select",""],["","17478071710","KETOTIF","DRO 0.025%OP","5","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","49884072703","DOXYCYC","CAP 100MG","14","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","12","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":""}]}]}