{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KATHRYNE E WRIGHT","gend":1,"add":"107B STRATFORD ROAD","city":"WILLIAMSBURG","state":"VA","zip":"23185-9998","dob":"1987-02-16","age":"","mstatus":"","insh":"2084518*01","cliId":"","pno":7572060581,"cno":7572060581,"email":"","ename":"","eno":"","pphy":"PARIKH, PRANAV MD","ppno":7576453150,"pcpadd":"STE 400 400 SENTARA CIR,","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":"23188-9998","pcpcounty":"","pcpid":"","pcpname":"WILLIAMSBURG INTERNAL MEDICINE","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576453149,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R00.2","R06.00","F41.1","F11.20","F41.9","F60.3","F14.20","F33.9","F12.20","F13.20","F13.21","F43.21","G47.00","F14.21","S05.02XA","F14.10","F15.20","F13.10","Z03.818","Z20.822","R06.02","F17.200","H57.12","R41.82","R41.3","F19.10","R53.83","R11.0","H93.19","S80.12XA","S80.11XA","Z04.1"],"date":["2021-01-14","2021-01-14","2021-01-14","2022-10-18","2022-10-16","2022-10-16","2022-10-18","2022-09-20","2022-10-18","2022-10-18","2022-05-16","2022-07-19","2022-06-10","2022-10-16","2021-09-05","2022-08-24","2022-10-18","2022-05-10","2021-11-18","2021-11-18","2021-01-13","2023-09-20","2021-09-05","2023-09-20","2023-09-20","2023-09-20","2023-09-20","2023-09-20","2023-09-20","2023-09-20","2023-09-20","2023-09-20"],"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":[["","12496120803","SUBOXONE MIS","8-2MG","4","Select","Select",""],["","50383070016","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","51660093901","CETIRIZINE TAB","10MG","30","Select","Select",""],["","00135057602","FLONASE ALGY SPR","50MCG","10","Select","Select",""],["","29300046805","CLONIDINE TAB","0.1MG","7","Select","Select",""],["","00054040013","DESVENLAFAX TAB","50MG ER","30","Select","Select",""],["","50111056001","TRAZODONE TAB","50MG","7","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","6","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","51660093901","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","00135057602","FLONASE ALGY","SPR 50MCG","10","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","7","Select","Select",""],["","00054040013","DESVENLAFAX","TAB 50MG ER","14","Select","Select",""],["","29300046805","CLONIDINE","TAB 0.1MG","7","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":""}]}]}