{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KAITLYN FOLEY","gend":1,"add":"4100 SANTA MARIA DR","city":"CHESAPEAKE","state":"VA","zip":"23321-9998","dob":"1994-02-24","age":"","mstatus":"","insh":"2369139*01","cliId":"","pno":7576722265,"cno":7576722265,"email":"","ename":"","eno":"","pphy":"TAYLOR, ANDREA NP","ppno":7577381600,"pcpadd":"2613 TAYLOR RD STE 201,","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":"23321-9998","pcpcounty":"","pcpid":"","pcpname":"Bon Secours Western Branch Primary Care","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574658616,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.10","F33.0","F41.9","F43.10","F31.72","O36.5930","O98.419","B18.2","Z3A.36","F11.20","Z00.00","R61.","F31.60","M54.40","R20.0","R20.2","Z68.32","L03.90","L03.116","N17.9","O26.611","K85.10","O98.411","K80.20","B19.20","Z3A.12","O99.211","O99.331","Z20.828","F19.90","B17.10","E87.6","E83.42","E86.9","A41.9","O98.42","Z37.0","O98.32","O99.824","A60.00","Z20.822","O71.82","O99.344","F31.9","Z91.19","Z87.891","Z3A.37","V23.9","O80.","R80.9","N19.","M25.572","O99.323","F19.20","I82.4Y2","N17.0","E83.39","NO DATA","F17.210","I10.","D64.9","Z86.19","R74.8","R10.11","K76.0","Z33.1","O09.93","Z3A.32","Z23.","O99.611","S39.012A","M99.03","M99.05","M99.04","M99.02","M99.08","M99.01","M99.07","M99.06","M99.09","O98.413"],"date":["2022-11-21","2022-11-21","2023-04-04","2022-11-21","2022-11-21","2021-08-17","2021-08-12","2023-04-12","2021-08-12","2023-01-26","2022-08-18","2022-08-18","2022-08-18","2022-08-18","2022-08-18","2022-08-18","2022-08-18","2023-04-04","2023-04-12","2023-04-12","2021-02-23","2021-02-23","2021-02-23","2021-02-23","2021-08-17","2021-02-23","2021-02-23","2021-02-23","2021-11-30","2023-04-12","2023-01-26","2023-04-04","2023-04-04","2023-04-05","2023-04-05","2021-08-17","2021-08-20","2021-08-17","2021-08-17","2021-08-17","2021-08-17","2021-08-17","2021-08-17","2021-08-17","2021-08-17","2021-08-17","2021-08-20","2021-08-17","2021-08-20","2023-04-07","2023-04-07","2023-04-12","2021-08-17","2021-08-17","2023-04-03","2023-04-04","2023-04-08","2023-04-04","2023-04-04","2023-04-08","2023-04-04","2023-04-04","2021-02-03","2021-02-03","2021-02-03","2021-02-03","2021-07-15","2021-07-15","2021-07-15","2021-02-22","2022-08-25","2022-08-25","2022-08-25","2022-08-25","2022-08-25","2022-08-25","2022-08-25","2022-08-25","2022-08-25","2022-08-25","2021-08-20"],"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":[["","51672413001","LAMOTRIGINE","TAB 25MG","60","Select","Select",""],["","69076047601","GLYCOPYRROL","TAB 2MG","42","Select","Select",""],["","47781035703","BUPREN\/NALOX","MIS 8-2MG","7","Select","Select",""],["","65862037405","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","00093216568","NALOXONE HCL","SPR 4MG","2","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","7","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","60","Select","Select",""],["","61783000012","FC","2 FEMALE CONDOM","12","Select","Select",""],["","27808023301","DOXYCYCLINE HYCLATE","100 MG","14","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":""}]}]}