{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EMILY A SMITH","gend":1,"add":"5437 LILAC CRES CRES","city":"PORTSMOUTH","state":"VA","zip":"23703-9998","dob":"1982-10-22","age":"","mstatus":"","insh":"2494018*01","cliId":"","pno":7577938509,"cno":7577938509,"email":"","ename":"","eno":"","pphy":"HILLS, LISA M NP","ppno":7574836401,"pcpadd":"STE K 4053 TAYLOR ROAD,","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":"23321-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576863025,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C56.2","Z51.12","R63.4","C56.1","Z90.711","Z12.39","Z13.71","R19.00","R59.0","R97.1","R63.0","Z51.11","C56.9","C48.2","I10.","E86.0","R11.2","R59.9","N83.202","Z90.710","Z79.899","C80.1","R29.898","R53.81","I08.1","J90.","A41.9","N39.0","R00.0","N30.01","R06.02","E44.0","R54.","Z71.89","Z51.5","Z85.43","R07.9","C77.1","J98.11","R64.","J91.0","C78.6","Z68.1","E88.09","R74.01","D63.0","Z82.49"],"date":["2023-08-02","2023-03-27","2022-11-30","2023-02-02","2023-02-02","2023-02-02","2023-02-02","2022-09-01","2022-09-01","2023-03-20","2022-08-08","2023-05-26","2023-09-14","2022-10-25","2022-10-25","2023-06-20","2023-06-20","2023-03-31","2023-03-31","2023-08-29","2023-05-19","2023-06-08","2023-06-08","2023-08-30","2023-09-15","2023-09-15","2023-09-15","2023-09-14","2023-09-14","2023-06-20","2023-08-30","2023-08-30","2023-08-30","2023-08-30","2023-08-30","2023-09-15","2023-09-15","2023-08-29","2023-08-29","2023-08-29","2023-08-29","2023-08-29","2023-08-29","2023-08-29","2023-08-29","2023-08-29","2023-08-29"],"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":[["","00406051201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","69656010330","ZEJULA","100 MG","60","Select","Select",""],["","53746074501","PROMETHAZINE HCL","12.5 MG","32","Select","Select",""],["","68462010630","ONDANSETRON HCL","8 MG","30","Select","Select",""],["","65862039110","ONDANSETRON ODT","8 MG","30","Select","Select",""],["","00406051201","OXYCOD\/APAP TAB","5-325MG","12","Select","Select",""],["","69656010330","ZEJULA CAP","100MG","60","Select","Select",""],["","68180012202","CEPHALEXIN","500 MG","21","Select","Select",""],["","59651030030","TAMOXIFEN CITRATE","20 MG","30","Select","Select",""],["","72888000500","METOPROLOL TARTRATE","50 MG","90","Select","Select",""],["","65862050320","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","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":""}]}]}