{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARQUISHA MELVIN","gend":1,"add":"6621 GLENOAK DR APT 417","city":"NORFOLK","state":"VA","zip":"23513-9998","dob":"1993-07-12","age":"","mstatus":"","insh":"2440385*01","cliId":"","pno":7576986101,"cno":7576986101,"email":"","ename":"","eno":"","pphy":"NEWBY, JAMES E MD","ppno":7576276892,"pcpadd":"STE 220 930 MAJESTIC AVE,","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23504-9998","pcpcounty":"","pcpid":"","pcpname":"Primary Care Specialists","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576275809,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["B20.","Z12.4","B37.3","U07.1","J20.9","R50.9","F43.20","J06.9","J02.9","Z13.220","Z11.3","Z11.1"],"date":["2023-06-26","2021-10-08","2021-10-08","2021-06-22","2021-06-22","2021-06-22","2023-06-26","2022-12-16","2022-12-16","2023-06-26","2023-06-26","2023-06-26"],"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":[["","49702022813","TIVICAY","TAB 50MG","30","Select","Select",""],["","61958250101","BIKTARVY","TAB ","30","Select","Select",""],["","61958200201","DESCOVY","TAB 200\/25MG","30","Select","Select",""],["","00143980305","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00054001825","PREDNISONE","TAB 20MG","15","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","30","Select","Select",""],["","00574402435","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","68462011944","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","49702024613","DOVATO","50MG-300MG","30","Select","Select",""],["","00781185220","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","59267100001","PFIZER VACC INJ COVID-","19","0","Select","Select",""],["","61958250101","BIKTARVY TAB","","30","Select","Select",""],["","49702024613","DOVATO TAB","50-300MG","30","Select","Select",""],["","00781185220","AMOX\/K CLAV TAB","875-125","20","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":""}]}]}