{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BETTY E ORAVETS","gend":1,"add":"4105 WINCHESTER DR","city":"PORTSMOUTH","state":"VA","zip":"23707-9998","dob":"1966-02-07","age":"","mstatus":"","insh":"1006774*01","cliId":"","pno":7578448273,"cno":7578448273,"email":"","ename":"","eno":"","pphy":"BACI, GENTA MD","ppno":7574465955,"pcpadd":"825 FAIRFAX AVE STE 118,","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23507-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574465196,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","S60.221A","S60.211A","S62.111A","S02.2XXA","S00.31XA","Z23.","E66.9","E03.9","Z79.899","F17.210","J34.89","Z13.9","K43.9","R10.9","R00.1","R07.89","F11.21","M25.531","M79.641","R10.32","T50.904A","S79.911S","NO DATA","K59.00","B18.2","T50.901A","F11.10","T40.1X1A","E66.3","F17.200","Z12.11","M25.512","F41.9","I05.8","D31.32","E78.5","F40.00","I12.9","I44.0","J45.909","G47.30","N18.9","Z79.890","Z90.49","Z90.710","M16.11","J01.90","S09.91XA","Z12.39"],"date":["2023-09-06","2022-03-05","2022-03-05","2022-03-05","2022-03-05","2022-03-05","2023-07-07","2022-03-05","2023-09-12","2022-03-05","2022-08-13","2022-03-05","2022-04-02","2023-09-12","2022-04-02","2022-08-20","2022-08-13","2023-05-01","2022-03-05","2022-03-05","2022-04-02","2022-07-11","2023-07-07","2023-07-07","2023-07-07","2023-06-28","2022-07-11","2022-07-11","2022-07-11","2023-06-28","2023-09-12","2023-06-28","2021-07-19","2022-08-13","2022-08-16","2022-03-25","2022-08-13","2022-08-13","2022-08-13","2022-08-13","2022-08-13","2022-08-13","2022-08-13","2022-08-13","2022-08-13","2022-08-13","2023-09-12","2023-09-12","2023-09-12","2023-09-12"],"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":[["","67877043005","ARIPIPRAZOLE","2 MG","90","Select","Select",""],["","00054002025","LITHIUM CARB","TAB 450MG ER","30","Select","Select",""],["","50228011501","FLUOXETINE","CAP 40MG","60","Select","Select",""],["","16729045615","LEVOTHYROXIN","TAB 175MCG","90","Select","Select",""],["","00781717612","NALOXONE","SPR 4MG","4","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","8","Select","Select",""],["","67877032005","IBUPROFEN","600 MG","20","Select","Select",""],["","50228011501","FLUOXETINE HCL","40 MG","180","Select","Select",""],["","62756043088","LITHIUM CARBONATE","300 MG","60","Select","Select",""],["","16729045615","LEVOTHYROXINE SODIUM","175 MCG","30","Select","Select",""],["","11523726808","MIRALAX","17 G","10","Select","Select",""],["","43598044874","NICOTINE PATCH","21 MG\/24HR","56","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":""}]}]}