{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DOUGLAS HARRIS","gend":0,"add":"1537 KINGSWOOD ST RM 1","city":"RICHMOND","state":"VA","zip":"23224-9998","dob":"1973-06-02","age":"","mstatus":"","insh":"2146828*01","cliId":"","pno":8047049507,"cno":8047049507,"email":"","ename":"","eno":"","pphy":"PAUL, CHRISTINE E MD","ppno":8042307777,"pcpadd":"4730 N SOUTHSIDE PLAZA,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":"23224-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8042302071,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["T40.601A","F33.1","R07.89","M54.9","F33.9","F41.1","F31.5","F17.200","I10.","I25.10","E78.5","Z79.82","Z98.61","F43.10","S61.411A","Z23.","T50.901A","F14.929","X58.XXXA","F11.129","R41.82","R10.9","R07.9","K21.9","Z79.02","F90.2","S69.91XA","W26.9XXA","R94.31","F31.30","F33.3","F14.20","M54.5","I20.0","F32.2","Z59.02","T50.904A","F20.9","F43.23","I44.4","F11.929","F33.2"],"date":["2021-03-22","2022-03-27","2023-08-13","2021-09-07","2022-02-20","2022-02-20","2023-01-09","2023-08-13","2023-08-13","2023-08-13","2023-08-13","2023-08-13","2022-07-05","2021-08-22","2022-09-14","2022-09-14","2023-03-27","2023-03-27","2023-03-27","2021-03-22","2023-08-13","2021-09-06","2023-08-13","2021-09-06","2021-09-06","2022-04-24","2022-09-14","2022-09-14","2023-08-13","2021-09-17","2022-03-07","2022-03-07","2021-09-07","2022-03-16","2022-04-22","2022-04-22","2022-09-15","2022-11-08","2023-07-27","2023-08-13","2023-08-13","2023-08-02"],"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":[["","13107003134","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","67877043003","ARIPIPRAZOLE","TAB 2MG","30","Select","Select",""],["","67877043003","ARIPIPRAZOLE TAB","2MG","30","Select","Select",""],["","13107003134","MIRTAZAPINE TAB","15MG","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":""}]}]}