{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAZMIN J MCKEITHAN","gend":1,"add":"64 LONG WOOD DR","city":"HAMPTON","state":"VA","zip":"23669-9998","dob":"1996-04-29","age":"","mstatus":"","insh":"2191745*01","cliId":"","pno":7579025901,"cno":7579025901,"email":"","ename":"","eno":"","pphy":"FAULK, CHARLIE M MD","ppno":7572493000,"pcpadd":"401 OYSTER POINT ROAD SUITE A,","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":"23602-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7572694424,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.9","F11.20","F12.20","Z86.59","R10.9","F17.210","F33.2","D50.9","E28.2","R53.83","F10.239","N39.0","B96.89","R11.2","V62.84","F11.10","T40.601A","R19.8","R19.7","R19.5","L22.","F11.23","F14.20","Z62.810","Z91.51","F41.1","M19.90","Z32.02","Z30.011","S50.811A","Z20.822","I10.","F41.9","F32.9","F43.10","NO DATA","Z88.5","F60.3","M15.9","K02.9","Z79.899","Z91.030","K08.89","F12.988","R10.84","G89.29","R40.20","R06.89","H57.03","T40.2X1A","F19.10","N30.00","N76.0","Z20.2","R10.2"],"date":["2022-08-01","2021-11-18","2022-08-01","2021-02-26","2021-02-28","2023-08-21","2021-02-26","2021-02-28","2023-04-13","2022-08-01","2022-08-06","2021-03-15","2023-08-21","2021-02-07","2021-11-11","2021-11-11","2022-10-09","2021-07-13","2021-07-13","2021-07-13","2021-07-13","2022-08-01","2022-08-01","2022-08-01","2022-08-01","2022-08-01","2022-08-01","2023-04-13","2023-04-13","2021-02-23","2021-11-11","2021-04-28","2021-11-12","2021-04-28","2021-11-12","2021-11-11","2023-04-07","2021-11-12","2022-08-01","2023-04-07","2023-04-07","2023-04-07","2023-04-07","2021-02-07","2021-02-07","2021-02-07","2022-10-08","2022-10-08","2022-10-08","2022-10-08","2022-10-09","2023-08-21","2023-08-21","2023-08-21","2023-08-21"],"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":[["","00093117210","PENICILLIN V POTASSIUM","250 MG","40","Select","Select",""],["","49483060350","IBUPROFEN","600 MG","40","Select","Select",""],["","59779076678","PAIN RELIEF","325 MG","50","Select","Select",""],["","00555901658","SPRINTEC","0.25-0.035","28","Select","Select",""],["","50111033401","METRONIDAZOLE","500 MG","14","Select","Select",""],["","70710113908","FLUCONAZOLE","150 MG","1","Select","Select",""],["","53489011905","DOXYCYCLINE HYCLATE","100 MG","14","Select","Select",""],["","68180012202","CEPHALEXIN","500 MG","40","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":""}]}]}