{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CASSANDRA  R HARRIS","gend":1,"add":"817 15 1 2 ST APT D","city":"VIRGINIA BEACH","state":"VA","zip":"23451-9998","dob":"1975-04-16","age":"","mstatus":"","insh":"1347515*01","cliId":"","pno":7577297804,"cno":7577297804,"email":"","ename":"","eno":"","pphy":"MALIAKAL, ALVIN MD","ppno":7574468920,"pcpadd":"825 FAIRFAX AVE STE 445","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23507-9998","pcpcounty":"","pcpid":"","pcpname":"EVMS Internal Medicine","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574465242,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z23.","M76.60","M77.32","M25.572","M79.672","B20.","I10.","E78.5","E55.9","NO DATA","Z13.220","Z11.3","N93.9","Z87.891","Z00.00","F32.9","Z12.11","Q43.9","F39.","T50.902A","Z21.","T39.1X2A","F19.10","Z65.8","M76.61","L50.9","M25.511","M54.12","S46.001A","M06.9","Z98.84","Z88.2","Z88.1","M79.603","M54.2","S60.222A","T71.9XXA","S06.9X9A","R07.9","M25.512","R13.10","E66.01","Z68.27","Z88.3","M77.50","Z12.39","R03.0","Z01.818","M76.62","M62.08","R39.9","R55.","K52.9","R10.13","K44.9","F43.20","K91.2","R11.2","R20.2","F43.9","Z86.39","Z91.11","Z68.20","Z01.812","Z20.822","K29.70","Z13.1","M19.90","N30.00","G47.00","Z68.42","R53.81","S86.012D","M92.62","I87.2","S90.822A","R73.03","M79.89","Z00.01"],"date":["2023-03-10","2021-08-08","2021-08-08","2021-09-02","2021-09-02","2023-03-10","2022-08-19","2022-02-18","2022-02-22","2023-03-10","2023-03-10","2023-03-10","2022-02-18","2023-03-10","2022-02-22","2021-04-15","2023-03-10","2021-01-18","2021-06-28","2021-02-25","2022-08-19","2021-02-25","2021-02-25","2021-02-25","2021-06-18","2021-09-21","2022-04-09","2022-02-22","2021-10-30","2022-04-09","2023-03-10","2022-08-19","2022-08-19","2021-10-30","2022-04-09","2022-04-09","2022-04-09","2022-04-09","2022-04-09","2022-04-09","2022-04-09","2022-08-19","2022-04-09","2022-04-09","2023-03-10","2023-03-10","2023-03-10","2021-06-28","2021-07-07","2022-02-22","2022-02-22","2021-03-22","2021-03-22","2021-01-22","2021-01-22","2021-06-17","2022-09-26","2022-08-26","2022-08-26","2022-08-26","2022-09-26","2022-09-26","2022-09-26","2021-01-14","2021-02-24","2021-01-22","2021-04-15","2021-04-15","2022-08-19","2022-08-19","2022-08-19","2022-08-19","2021-07-07","2021-07-07","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2021-09-25"],"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":[["","65862085901","FAMOTIDINE","TAB 20MG","180","Select","Select",""],["","61958210101","ODEFSEY","200-25-25","30","Select","Select",""],["","65862001230","SERTRALINE","TAB 50MG","30","Select","Select",""],["","65862019430","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","28","Select","Select",""],["","65862050320","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","80777027398","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","58160088752","FLUARIX QUAD","INJ 2021-22","0","Select","Select",""],["","46581083006","SALONPAS GEL","PAD 0.04","18","Select","Select",""],["","00603533815","PREDNISONE","PAK 10MG","21","Select","Select",""],["","65162079108","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","40","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","60","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","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":""}]}]}