{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIARA N REDD","gend":1,"add":"109 INDIAN OAK AVE","city":"CREWE","state":"VA","zip":"23930-9998","dob":"1993-04-30","age":"","mstatus":"","insh":"1656214*01","cliId":"","pno":4343153738,"cno":4343153738,"email":"","ename":"","eno":"","pphy":"HUYNH, VINH THINH T MD","ppno":4343155340,"pcpadd":"935 S MAIN ST,","pcpcity":"FARMVILLE","pcpstate":"VA","pcpzip":"23901-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4343152859,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O88.23","I26.99","O99.325","E87.1","R65.10","Z20.822","O99.285","T38.5X5A","F12.90","E80.7","Z87.59","Z79.899","Z3A.10","O80.","Z37.0","Z3A.39","R07.9","R07.81","R06.02","K76.9","Z72.0","R17.","M54.9","Z3A.35","O47.00","N91.2","Z3A.01","R07.89","Z88.0","Z87.891","J02.9","Z30.430","O99.824","L03.116","L02.416","S70.362A","W57.XXXA","M79.89"],"date":["2022-03-15","2022-06-03","2022-03-15","2022-03-15","2022-03-15","2023-01-30","2022-03-15","2022-03-15","2022-03-15","2022-03-15","2022-03-15","2022-03-15","2021-07-08","2022-03-14","2022-01-28","2022-01-28","2023-01-30","2023-01-30","2023-01-30","2023-01-30","2023-01-30","2022-03-15","2021-12-29","2021-12-29","2021-12-29","2021-06-11","2021-06-11","2022-03-14","2022-03-14","2022-03-14","2021-04-29","2022-05-11","2022-01-28","2023-07-31","2023-07-31","2023-07-27","2023-07-27","2023-07-31"],"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":[]},{"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":[["","70000052601","STOOL SOFTNR TAB","8.6-50MG","14","Select","Select",""],["","00003089421","ELIQUIS TAB","5MG","74","Select","Select",""],["","47781019605","OXYCOD\/APAP TAB","5-325MG","28","Select","Select",""],["","00093031401","KETOROLAC TAB","10MG","16","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","14","Select","Select",""],["","64380078408","PREDNISONE","10 MG","6","Select","Select",""],["","68180012202","CEPHALEXIN","500 MG","28","Select","Select",""],["","70000052601","STOOL SOFTNR","TAB 8.6-50MG","14","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","74","Select","Select",""],["","47781019605","OXYCOD\/APAP","TAB 5-325MG","28","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","16","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":""}]}]}