{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KATRINIA  C BELL","gend":1,"add":"741 MONTICELLO AVE 7447 CENTRAL BUSINESS PARK DRIVE","city":"NORFOLK","state":"VA","zip":"23510-9998","dob":"1977-06-16","age":"","mstatus":"","insh":"20038425*01","cliId":"","pno":7572359523,"cno":7572359523,"email":"","ename":"","eno":"","pphy":"MARKOVIC, VLADIMIR MD","ppno":7575339108,"pcpadd":"155 KINGSLEY LANE SUITE 320,","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23505-9998","pcpcounty":"","pcpid":"","pcpname":"Hampton Roads Community Health Center","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576226384,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F14.20","F10.20","F20.9","F12.10","R52.","E11.9","K21.9","R53.83","G44.209","Z76.5","Z20.822","M79.606","F20.0","V58.69","Z91.128","F17.210","Z53.29","R44.3","J20.9","F17.200","NO DATA","R07.9","F25.0","G44.89","J02.0","H92.01","R51.9","J02.9","R13.0","E87.6","V62.84","Z91.51","Z91.14","Z91.410","Z91.411","Z59.00","G40.909","F14.10","J35.1","T14.90XA","F09.","F25.9","M25.562","R44.0","R44.1","M79.671","M79.672","F43.10","G47.00","M79.604","F15.20","F33.2","R07.89","F22.","R10.9","R45.1","F14.90","F10.129","N30.00","R50.9","M54.9","R06.02","Z86.59","Z86.19","S02.832A","S02.2XXA","S02.40DA","F10.10","J40.","R69.","Z79.84","R09.81","Z62.810","Z82.49","F10.920","R42.","T50.904A","F06.8","F29.","E78.00","D64.9","Z83.3","E87.8","F31.9","S02.32XA"],"date":["2022-12-12","2023-01-30","2023-07-06","2022-12-12","2023-05-09","2023-07-06","2022-08-13","2022-08-13","2023-02-24","2023-03-23","2022-09-06","2021-02-26","2023-04-18","2022-03-21","2022-03-21","2023-07-06","2023-03-23","2022-03-21","2022-05-04","2022-05-04","2023-06-24","2023-07-06","2022-08-29","2023-06-24","2022-09-06","2022-09-06","2023-06-24","2022-09-06","2022-09-06","2022-09-06","2022-08-13","2022-08-13","2022-08-13","2022-08-13","2022-08-13","2023-04-18","2022-08-13","2023-07-06","2022-09-06","2023-04-18","2021-05-14","2021-05-23","2021-10-14","2022-03-21","2022-03-21","2023-03-23","2023-03-23","2021-03-01","2021-03-01","2021-03-01","2021-03-25","2021-03-25","2022-08-11","2022-08-27","2023-02-24","2022-08-12","2022-10-31","2022-10-31","2022-12-20","2023-02-24","2023-02-24","2023-02-24","2023-02-24","2023-02-24","2023-04-18","2023-04-18","2023-04-18","2023-04-18","2022-05-09","2022-08-11","2022-05-04","2022-05-04","2022-08-11","2022-08-11","2022-10-31","2022-10-31","2022-10-31","2023-01-30","2023-05-09","2023-07-06","2023-07-06","2023-07-06","2023-07-06","2023-06-24","2023-04-18"],"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":[["","00527179101","FLUPHENAZINE","TAB 10MG","60","Select","Select",""],["","55111016805","OLANZAPINE","TAB 20MG","30","Select","Select",""],["","00121467500","VALPROIC ACD","SOL 250\/5ML","900","Select","Select",""],["","68462013801","OXCARBAZEPIN","TAB 300MG","60","Select","Select",""],["","67877056310","METFORMIN","TAB 1000MG","60","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","64380071207","BENZONATATE","CAP 100MG","30","Select","Select",""],["","00904530780","BANOPHEN","CAP 50MG","30","Select","Select",""],["","55150026705","FLUPHENAZ DE","INJ 25MG\/ML","5","Select","Select",""],["","00904617250","CARBAMAZEPIN","TAB 200MG","60","Select","Select",""],["","50111056003","TRAZODONE","TAB 50MG","30","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","40","Select","Select",""],["","70954027610","FLUPHENAZINE HCL","10 MG","60","Select","Select",""],["","50111056003","TRAZODONE HCL","50 MG","30","Select","Select",""],["","00904617250","CARBAMAZEPINE","200 MG","60","Select","Select",""],["","55111016805","OLANZAPINE TAB","20MG","30","Select","Select",""],["","00527179101","FLUPHENAZINE TAB","10MG","60","Select","Select",""],["","00121467500","VALPROIC ACD SOL","250\/5ML","900","Select","Select",""],["","68462013801","OXCARBAZEPIN TAB","300MG","60","Select","Select",""],["","67877056310","METFORMIN TAB","1000MG","60","Select","Select",""],["","64380071207","BENZONATATE CAP","100MG","30","Select","Select",""],["","16571040250","CETIRIZINE TAB","10MG","30","Select","Select",""],["","42023012901","FLUPHENAZ DE INJ","25MG\/ML","5","Select","Select",""],["","00904617250","CARBAMAZEPIN TAB","200MG","60","Select","Select",""],["","00904530780","BANOPHEN CAP","50MG","30","Select","Select",""],["","50111056003","TRAZODONE TAB","50MG","30","Select","Select",""],["","65862018601","CLINDAMYCIN CAP","300MG","40","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":""}]}]}