{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JASODRA BISNAUTH","gend":1,"add":"3110 WESTMINSTER AVE","city":"NORFOLK","state":"VA","zip":"23504-9998","dob":"1965-08-11","age":"","mstatus":"","insh":"20084594*01","cliId":"","pno":7573432152,"cno":7573432152,"email":"","ename":"","eno":"","pphy":"WARE, JENNIFER L MD","ppno":7573889925,"pcpadd":"7401 GRANBY ST,","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23505-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Internal Medicine Physicians - Wards Corner","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7579658519,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D61.818","K74.60","R16.1","D25.9","I83.90","I72.8","Z96.89","F25.9","R44.0","F29.","E46.","D69.6","F06.0","R46.89","H61.23","D72.819","R53.81","R73.9","Z12.11"],"date":["2023-01-31","2023-01-24","2022-07-19","2022-07-19","2022-07-19","2022-07-19","2022-07-19","2022-10-06","2023-01-03","2023-01-03","2023-01-03","2023-01-03","2022-10-06","2022-11-01","2022-10-08","2022-11-01","2022-11-01","2022-11-01","2023-01-24"],"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":[["","29300014801","QUETIAPINE","TAB 50MG","90","Select","Select",""],["","29300014801","QUETIAPINE FUMARATE","50 MG","90","Select","Select",""],["","10135015461","BISACODYL","5 MG","4","Select","Select",""],["","68180035209","SERTRALINE HCL","50 MG","30","Select","Select",""],["","67877021905","CEPHALEXIN","500 MG","10","Select","Select",""],["","69238112309","NADOLOL","20 MG","30","Select","Select",""],["","29300014801","QUETIAPINE TAB","50MG","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":""}]}]}