{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JADA   R JACKSON","gend":1,"add":"2307 OAK AVE","city":"NEWPORT NEWS","state":"VA","zip":"23607-9998","dob":"2002-04-15","age":"","mstatus":"","insh":"7913664*01","cliId":"","pno":"757\/927-0673 5802356693 ","cno":"","email":"","ename":"","eno":"","pphy":"HILSINGER, KATHERINE L MD","ppno":"757\/874-2229","pcpadd":"101 EATON ST SUITE 300","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":23669,"pcpcounty":"","pcpid":"","pcpname":"MAWC - Center for Women's Health","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/875-1525","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.3","F90.0","Z63.9","B36.9","N94.818","Z30.015","F43.12","N30.01","Z20.822","R19.7","R43.0","R09.81","Z20.828","NO DATA","N64.4","F17.200","R21.","R30.0","F33.2","N89.8","Z11.3","Z32.02","R10.2","N76.0","N94.89","Z86.19","Z30.09","U07.1"],"date":["2020-04-14","2020-04-14","2020-04-14","2020-11-09","2021-04-01","2021-04-01","2020-01-30","2021-03-29","2021-06-13","2020-12-31","2020-12-31","2020-12-31","2020-12-31","2020-11-09","2020-11-09","2020-11-09","2020-11-09","2020-01-30","2020-02-12","2021-04-30","2021-04-30","2021-04-30","2021-06-13","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2020-12-31"],"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":[["","68180012202","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","45802001402","HYDROCORT","OIN 0.025","30","Select","Select",""],["","00093767902","ETONOGESTREL","MIS ETHY EST","1","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","68682045570","METRONIDAZOL","GEL 0.75%VAG","70","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","","SERTRALINE","TAB 50MG","","Select","Select",""],["","","ARIPIPRAZOLE","TAB 5MG","","Select","Select",""],["","","TRAZODONE","TAB 50MG","","Select","Select",""],["","","PHENAZOPYRID","TAB 200MG","","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":""}]}]}