{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"QUANYAJAH S SCARBOR","gend":1,"add":"1604 DELEVAN ST","city":"NORFOLK","state":"VA","zip":"23523-9998","dob":"2000-04-19","age":"","mstatus":"","insh":"7028458*01","cliId":"","pno":7572307161,"cno":7572307161,"email":"","ename":"","eno":"","pphy":"PIRKLE, GINIENE M MD","ppno":7574666350,"pcpadd":"STE 2200 880 KEMPSVILLE RD,","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23502-9998","pcpcounty":"","pcpid":"","pcpname":"MAWC - The Group for Women","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574669262,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z32.01","Z36.89","Z13.79","E66.9","V23.7","G89.18","I50.9","D64.9","E87.6","O48.0","Z37.0","O99.02","O99.214","O76.","Z3A.41","Z01.812","Z20.822","J96.01","R06.02","I50.31","Z68.42","O90.89","I11.0","E66.01","Z77.22","Z79.899","Z36.2","Z3A.24","Z34.02","Z23.","O99.53","Z39.1","O77.0","R07.9","I50.30"],"date":["2021-10-11","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2022-03-21","2022-03-29","2022-03-29","2022-03-28","2022-03-18","2022-03-18","2022-03-16","2022-03-16","2022-03-18","2022-03-18","2022-03-16","2022-03-26","2022-03-29","2022-03-29","2022-03-26","2022-03-26","2022-03-26","2022-03-26","2022-03-26","2022-03-26","2022-03-26","2021-11-24","2021-11-24","2021-11-24","2021-11-24","2022-03-26","2022-03-14","2022-03-18","2022-03-26","2022-03-28"],"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":[["","58602075521","PAIN RELIEF TAB","500MG","60","Select","Select",""],["","11822316500","RA COL-RITE CAP","100MG","30","Select","Select",""],["","00904759080","FEROSUL TAB","325MG","60","Select","Select",""],["","65162004710","OXYCODONE TAB","5MG","20","Select","Select",""],["","51672130200","TERCONAZOLE CRE","0.8%","20","Select","Select",""],["","00904699860","DOCUSATE SOD CAP","100MG","30","Select","Select",""],["","00054429731","FUROSEMIDE TAB","20MG","7","Select","Select",""],["","00904673080","ACETAMIN TAB","500MG","60","Select","Select",""],["","00904759161","FERROUS SULF TAB","325MG","60","Select","Select",""],["","65162046650","IBUPROFEN TAB","800MG","60","Select","Select",""],["","82607066026","FLOWFLEX KIT TEST","","8","Select","Select",""],["","58602075521","PAIN RELIEF","TAB 500MG","60","Select","Select",""],["","51672130200","TERCONAZOLE","CRE 0.008","20","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","8","Select","Select",""],["","11822316500","RA COL-RITE","CAP 100MG","30","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","60","Select","Select",""],["","65162004710","OXYCODONE","TAB 5MG","20","Select","Select",""],["","00904699860","DOCUSATE SOD","CAP 100MG","30","Select","Select",""],["","00904673080","ACETAMIN","TAB 500MG","60","Select","Select",""],["","00904759161","FERROUS SULF","TAB 325MG","60","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","00054429731","FUROSEMIDE","TAB 20MG","7","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":""}]}]}