{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRITTANY L SMITH","gend":1,"add":"1435 PECAN CT","city":"VIRGINIA BEACH","state":"VA","zip":"23453-9998","dob":"1987-06-03","age":"","mstatus":"","insh":"20056037*01","cliId":"","pno":7572149083,"cno":7572149083,"email":"","ename":"","eno":"","pphy":"ASUNCION, CHRISTOPHER W MD","ppno":7577055265,"pcpadd":"828 HEALTHY WAY","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23462-9998","pcpcounty":"","pcpid":"","pcpname":"Mid-Atlantic Family Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7579622884,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","F43.10","F14.20","N18.6","Z99.2","F15.221","F60.3","F11.21","F15.20","Z72.0","Z13.41","F90.9","F41.9","F33.9","Z76.0","Z65.8","Z65.2","E11.9","NO DATA","F90.0","M54.16","R53.83","F11.20","F15.259","K21.9","E66.9","E11.65","Z79.84","Z20.828","V62.85","F15.10","F17.210","Z86.16","Z20.822","R22.30","F84.0","Z02.9","F19.21","D64.9","K25.9","Z03.89","R46.89","R45.89","F30.10","U07.1","E66.01","F41.1","F22.","F19.10","M54.32","R45.1","F99.","F23.","L70.0","L81.4","I10.","E11.40","R00.0","K29.70","Z13.89","Z51.81","Z32.02","F17.200","Z59.0","Z79.891","F39."],"date":["2023-02-01","2023-02-01","2023-02-01","2021-07-15","2021-06-22","2023-02-01","2023-02-01","2023-02-01","2021-12-02","2021-12-02","2021-12-02","2021-12-02","2023-02-01","2021-12-02","2023-03-21","2023-02-01","2023-02-01","2023-03-21","2023-01-25","2021-09-29","2021-12-29","2021-04-11","2021-04-07","2021-04-15","2021-06-28","2021-09-03","2021-06-01","2021-06-01","2021-06-24","2023-05-18","2023-05-18","2023-05-18","2023-05-18","2023-05-18","2021-06-02","2021-06-17","2021-06-17","2021-06-17","2021-07-15","2021-09-03","2021-10-05","2023-05-19","2023-05-19","2021-04-10","2021-04-10","2021-04-10","2021-09-29","2021-03-16","2021-03-16","2021-03-16","2021-03-17","2021-03-17","2021-03-27","2021-01-28","2021-01-28","2021-01-31","2021-03-10","2021-03-26","2021-06-28","2021-04-07","2021-04-07","2021-03-22","2021-04-07","2021-04-07","2021-05-03","2022-06-28"],"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":[["","00006027731","JANUVIA","100 MG","30","Select","Select",""],["","70010006505","METFORMIN","TAB 1000MG","60","Select","Select",""],["","13668001101","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","70436001004","BUPROPN HCL","TAB 150MG XL","30","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","12","Select","Select",""],["","70436001002","BUPROPION XL","150 MG","30","Select","Select",""],["","70010006505","METFORMIN HCL","1000 MG","60","Select","Select",""],["","13668001105","CITALOPRAM HBR","40 MG","30","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":""}]}]}