{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TYMELYA ARCHER","gend":1,"add":"850 W 34TH ST APT 4","city":"NORFOLK","state":"VA","zip":"23508-9998","dob":"1999-08-26","age":"","mstatus":"","insh":"2424430*01","cliId":"","pno":7577629327,"cno":7577629327,"email":"","ename":"","eno":"","pphy":"HOWELL, CHRISTINE NP","ppno":7579552828,"pcpadd":"885 KEMPSVILLE RD STE 320,","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23502-9998","pcpcounty":"","pcpid":"","pcpname":"Amelia Medical Associates","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7579552829,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["U07.1","F41.9","R07.9","R06.00","J45.909","Z82.49","R06.02","NO DATA","G89.29","F06.8","N73.0","N94.10","Z32.02","S00.11XA","S06.0X0A","R42.","I49.8","I49.1","F31.9","Z79.899","Z02.89","R51.9","R05.9","Z20.828","Z30.46","Z01.419","Z12.39","V58.89","Z11.3","R10.12","Z68.22","Z01.411","A60.9","N92.6","R39.9","Z11.4","R87.613","R87.810","R10.2","N92.1","N83.202","N83.291","N83.209","N87.1","O23.591","N30.00","B96.89","Z3A.01","R10.9"],"date":["2021-12-25","2022-09-14","2022-01-31","2022-01-31","2022-01-31","2022-01-31","2022-01-31","2023-06-12","2023-06-12","2022-09-14","2023-02-07","2023-02-07","2023-05-15","2022-05-09","2022-05-09","2022-11-18","2022-11-15","2022-11-15","2022-11-15","2022-11-15","2023-04-06","2022-10-18","2021-12-25","2022-05-31","2023-01-26","2022-06-24","2022-06-24","2022-06-24","2023-04-28","2022-06-24","2022-06-24","2023-04-28","2023-04-28","2023-04-28","2023-04-28","2023-04-28","2023-05-15","2023-05-15","2023-05-11","2023-05-11","2023-05-11","2023-07-19","2023-05-11","2023-08-04","2023-09-22","2023-09-22","2023-09-22","2023-09-22","2023-09-22"],"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":[["","00115180401","HYDROXYZ PAM CAP","50MG","360","Select","Select",""],["","50111056001","TRAZODONE TAB","50MG","30","Select","Select",""],["","33342007007","OLANZAPINE TAB","10MG","30","Select","Select",""],["","00116200116","CHLORHEX GLU SOL","0.12%","473","Select","Select",""],["","31722070430","VALACYCLOVIR TAB","500MG","60","Select","Select",""],["","31722070430","VALACYCLOVIR","500 MG","90","Select","Select",""],["","00093005805","TRAMADOL HCL","50 MG","35","Select","Select",""],["","00406051201","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","12","Select","Select",""],["","33342007007","OLANZAPINE","TAB 10MG","30","Select","Select",""],["","00116200116","CHLORHEX GLU","SOL 0.0012","473","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","00115180401","HYDROXYZ PAM","CAP 50MG","360","Select","Select",""],["","68682045570","METRONIDAZOLE","0.75 %","70","Select","Select",""],["","68180012202","CEPHALEXIN","500 MG","28","Select","Select",""],["","50428036208","PRENATAL GUMMIES","180-35-25","90","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":""}]}]}