{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MONA P PARSON","gend":1,"add":"1015 NANSEMOND PKWY APT 504E","city":"SUFFOLK","state":"VA","zip":"23434-9998","dob":"1973-05-08","age":"","mstatus":"","insh":"20069742*01","cliId":"","pno":7572856269,"cno":7572856269,"email":"","ename":"","eno":"","pphy":"WHITBY, YARNELL SHARNEA FNP","ppno":7579251866,"pcpadd":"157 N MAIN ST STE A","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":"23434-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7579421282,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.11","N39.3","R03.0","Z68.44","I26.99","M17.0","F20.9","R60.9","F31.9","N39.46","R39.14","R35.1","R35.0","R39.15","M25.569","E66.01","M79.89","Z13.89","Z13.9","M25.561","G40.909","K21.9","Z01.411","T19.2XXA","E66.9","R60.0","R56.9","NO DATA","Z79.899","G47.30","Z13.220","Z13.29","Z13.228","Z12.4","Z13.0","Z12.11","Z12.39","N39.0"],"date":["2023-04-20","2023-05-02","2022-12-27","2023-05-02","2023-05-02","2023-02-03","2023-02-03","2023-02-03","2023-02-03","2023-05-09","2023-04-24","2023-04-24","2023-04-24","2023-03-21","2021-04-08","2022-10-31","2023-03-01","2023-02-02","2023-02-02","2023-05-02","2023-05-02","2021-03-18","2023-01-02","2023-01-02","2023-01-02","2023-02-03","2023-02-14","2022-10-23","2022-10-23","2022-10-31","2022-10-31","2022-10-31","2022-10-31","2022-10-31","2022-10-31","2022-10-31","2022-10-31","2023-01-12"],"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":[["","13107003234","MIRTAZAPINE","TAB 45MG","30","Select","Select",""],["","68462015305","TOPIRAMATE","50 MG","30","Select","Select",""],["","67877043103","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","00003089470","ELIQUIS","5 MG","60","Select","Select",""],["","65862017760","CEFDINIR","300 MG","14","Select","Select",""],["","50111033402","METRONIDAZOLE","500 MG","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":""}]}]}