{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CASSANDRA ROESLER","gend":1,"add":"8916 LONDON ST","city":"NORFOLK","state":"VA","zip":"23503-9998","dob":"1992-09-19","age":"","mstatus":"","insh":"20069074*01","cliId":"","pno":4196858331,"cno":4196858331,"email":"","ename":"","eno":"","pphy":"KAMEL, NANCY MD","ppno":7578212088,"pcpadd":"1232 PERIMETER PKWY SUITE 101,","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23454-9998","pcpcounty":"","pcpid":"","pcpname":"TPMG CORPORATE LANDING INTERNAL FAM MEDICINE","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7578212081,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.2","M35.7","R00.0","G90.8","G47.419","R20.2","R07.0","R63.4","K59.00","R10.30","R14.0","R13.14","R12.","I49.8","E87.6","J30.9","K90.41","F41.1","F33.1","F90.0","M62.81","M25.552","Q79.60","R52.","R06.02","F17.210","Z88.5","Z91.013","R42.","R29.818","V58.69","Z82.49","Z83.3","Z80.1","Z81.8","Z80.42","L70.0","M25.359","Z72.0","G57.03","M99.03","M76.31","M99.05","M76.892","M99.04","M76.891","M76.32","Z12.4","Z30.46","M53.3","M47.816","R51.9","H35.413","H43.823","H43.393","R00.2","M25.351","L29.9","T78.3XXA","Z68.23","M54.9","R07.9","Z71.1","NO DATA","R20.0","H04.123","S76.212A","S39.011A","R10.32","Z20.822","G89.29"],"date":["2022-05-26","2021-08-06","2021-08-06","2021-08-06","2022-09-10","2022-04-24","2022-01-06","2022-07-13","2022-09-10","2022-07-13","2022-07-13","2022-07-13","2022-07-13","2022-07-13","2022-07-13","2021-11-08","2021-11-08","2022-08-03","2022-08-03","2022-08-03","2022-08-23","2022-08-23","2022-08-23","2022-07-23","2021-11-18","2022-09-10","2022-09-10","2022-09-10","2022-07-23","2022-07-23","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2021-01-22","2021-01-22","2021-01-22","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2021-11-10","2021-11-10","2022-05-23","2022-05-23","2022-05-23","2022-07-18","2022-07-18","2022-07-18","2022-08-22","2021-07-28","2021-07-28","2021-07-28","2021-07-28","2022-05-09","2021-11-18","2021-12-09","2022-05-26","2022-07-23","2022-08-10","2021-09-29","2021-09-30","2021-09-30","2021-11-08","2022-05-26"],"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":[["","59417010310","VYVANSE","CAP 30MG","60","Select","Select",""],["","70436015301","POT CHLORIDE","TAB 20MEQ ER","30","Select","Select",""],["","59267102504","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","00245531911","KLOR-CON M20","TAB 20MEQ ER","30","Select","Select",""],["","59417010310","VYVANSE CAP","30MG","60","Select","Select",""],["","59267102504","PFIZER VACC INJ ADLT RTU","","0","Select","Select",""],["","70436015301","POT CHLORIDE TAB","20MEQ ER","30","Select","Select",""],["","00245531911","KLOR-CON M","20 TAB 20MEQ ER","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":""}]}]}