{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ARIEL J WALKER","gend":1,"add":"1509 KING ST","city":"PORTSMOUTH","state":"VA","zip":"23704-9998","dob":"1991-08-12","age":"","mstatus":"","insh":"2294877*01","cliId":"","pno":7573727936,"cno":7573727936,"email":"","ename":"","eno":"","pphy":"DIXON, MARYBETH MD","ppno":7577934710,"pcpadd":"850 KEMPSVILLE RD SUITE 100A,","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23502-9998","pcpcounty":"","pcpid":"","pcpname":"MAWC - Womancare Centers, PLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7579043694,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z01.419","Z30.45","B35.4","J45.909","K21.9","G43.909","R21.","J40.","Z20.822","R05.9","O21.1","R64.","E44.0","Z3A.11","O99.281","E83.42","E83.39","Z79.899","E86.1","O25.11","O99.011","D50.9","Z34.90","Z45.2","O21.0","R11.2","E44.1","F41.1","Z63.0","O80.","R07.9","L30.9","O21.9","E87.6","O26.90","E87.2","Z39.2","Z13.31","R11.10","Z32.02","Z30.430","Z3A.08","E86.0","R53.1","E87.1","Z30.432","Z30.09","M20.11","M20.12","M24.572","M24.571","M79.671","M43.6","N39.0","Z32.01","O99.511","O99.611","O99.351","Z3A.01","O23.11","N30.00","O99.891","R82.71","R11.0","O99.283","Z3A.00","O99.111","D64.9","D72.829","K59.00","Z3A.13","N92.6","O26.891","R00.0","O34.211","O76.","Z3A.38","Z37.0","O66.0","O69.81X0","R10.9","O26.893","R10.2","Z3A.33","O99.02","O70.0","O77.0","Z3A.39","O99.013","N20.0"],"date":["2023-04-18","2021-03-31","2021-05-16","2022-01-15","2022-01-15","2022-01-02","2021-05-16","2021-10-27","2022-08-18","2021-10-27","2022-02-13","2022-02-06","2022-02-06","2022-02-08","2022-02-22","2022-02-06","2022-02-06","2022-08-18","2022-02-06","2022-02-13","2022-02-22","2022-02-06","2022-02-06","2022-02-08","2022-04-05","2023-08-09","2022-02-22","2023-07-18","2023-07-18","2022-08-18","2021-01-10","2021-05-20","2022-02-04","2022-02-22","2022-02-06","2022-02-22","2022-10-04","2022-10-04","2022-02-22","2022-10-12","2022-10-12","2022-01-15","2022-02-05","2022-02-05","2022-02-06","2023-01-19","2023-04-18","2023-01-20","2023-01-20","2023-01-20","2023-01-20","2023-01-20","2021-09-17","2021-10-06","2021-12-22","2022-01-02","2022-01-02","2022-01-02","2022-01-02","2022-01-02","2022-01-02","2022-02-04","2022-02-04","2022-02-04","2022-02-05","2022-02-12","2022-02-13","2022-02-13","2022-02-13","2022-02-13","2022-02-13","2021-11-23","2022-02-02","2022-02-02","2022-08-18","2022-08-18","2022-08-18","2022-08-18","2022-08-18","2022-08-18","2023-08-09","2022-07-11","2022-07-11","2022-07-11","2022-08-18","2022-08-18","2022-08-18","2022-08-18","2022-08-18","2023-09-17"],"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":[["","16729029805","ONDANSETRON","INJ 40\/20ML","20","Select","Select",""],["","49884018601","DOXYL\/PYRID","TAB 10-10MG","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","45802075830","PROMETHAZINE","SUP 12.5MG","20","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","28","Select","Select",""],["","57896057501","PRENATAL","TAB ","30","Select","Select",""],["","00093220305","METOCLOPRAM","TAB 10MG","24","Select","Select",""],["","50742050504","SCOPOLAMINE","DIS 1MG\/3DAY","10","Select","Select",""],["","63323062610","SOD CHLORIDE","INJ 0.0045","1000","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","00093767902","ETONOGESTREL-ETHINYL ESTRADIOL .","12-.015MG","3","Select","Select",""],["","65862039010","ONDANSETRON ODT","4 MG","12","Select","Select",""],["","57237001401","TAMSULOSIN HCL","0.4 MG","14","Select","Select",""],["","42858010201","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","12","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":""}]}]}