{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ZAKYYAH RYAN","gend":1,"add":"400 MARS ST APT 15A","city":"PETERSBURG","state":"VA","zip":"23803-9998","dob":"1985-06-26","age":"","mstatus":"","insh":"20082100*01","cliId":"","pno":2673356206,"cno":2673356206,"email":"","ename":"","eno":"","pphy":"LIPATO, THOKOZENI MD","ppno":8048289357,"pcpadd":"1001 E LEIGH ST","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23298-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048285791,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D57.00","I12.9","N18.2","NO DATA","D57.1","Z30.013","D72.829","D63.1","N17.9","Z20.822","Z90.49","N18.9","D75.89","E86.9","G89.29","Z79.899","Z81.3","Z82.49","Z83.2","Z83.3","Z98.891","D64.9","G89.21","E83.111","F17.290","Z51.81","Z91.018","Z87.442","N18.1","G89.4","F11.20","R06.02","R05.1","R06.2","Z04.9","J96.21","J98.11","K59.03","T40.2X5A","Z91.199","Z91.14","R52.","J96.11","R01.1","M25.562","M25.561","M54.9","R53.83","Z91.19","J96.01"],"date":["2023-02-22","2022-10-20","2023-03-20","2022-10-21","2023-03-20","2022-07-29","2023-02-22","2022-10-20","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-02-22","2023-03-20","2022-10-11","2022-10-16","2022-10-10","2022-10-10","2022-10-10","2022-10-19","2022-10-19","2022-11-02","2022-11-02","2022-11-02","2022-06-15","2022-10-11","2022-10-11","2022-10-16","2022-10-16","2022-10-11","2022-10-11","2022-06-18","2022-06-14","2022-06-14","2022-06-14","2022-06-14","2022-06-14","2022-06-14","2022-06-14","2022-10-16"],"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":[["","00406577101","METHADONE","TAB 10MG","90","Select","Select",""],["","00054023625","MORPHINE SUL","TAB 30MG","180","Select","Select",""],["","00363032706","GENTLE LAXAT","TAB 5MG EC","30","Select","Select",""],["","00574705012","BISACODYL","SUP 10MG","12","Select","Select",""],["","49884072401","HYDROXYUREA","CAP 500MG","90","Select","Select",""],["","66993037083","MEDROXYPR AC","INJ 150MG\/ML","1","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","72786010101","OXBRYTA","500 MG","90","Select","Select",""],["","00054023625","MORPHINE SULFATE","30 MG","180","Select","Select",""],["","31722001230","DEFERASIROX","180 MG","30","Select","Select",""],["","00406577101","METHADONE HCL","10 MG","90","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":""}]}]}