{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NATALA JOHNSON","gend":1,"add":"4904 BURNT OAK DRIVE APT 402 NATALYA JOHNSON","city":"RICHMOND","state":"VA","zip":"23234-9998","dob":"1998-07-19","age":"","mstatus":"","insh":"8836183*01","cliId":"","pno":8047128713,"cno":8047128713,"email":"","ename":"","eno":"","pphy":"MOSCHLER JR, EDWARD F MD","ppno":"","pcpadd":"4221 CROSSINGS BLVD","pcpcity":"PRINCE GEORGE","pcpstate":"VA","pcpzip":"23875-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.0","F31.2","F14.20","F12.20","Z34.83","Z3A.35","F20.0","F29.","O60.03","F11.129","O99.344","F25.9","F14.10","O99.324","Z37.0","Z3A.37","O99.343","F31.9","F14.90","F12.90","V62.84","N39.0","Z03.818","Z3A.31","U07.1","Z91.14","A59.09","Z3A.33","F90.9","F41.9","R63.6","F12.10","Z79.899","Z87.891","Z88.0","Z79.1","Z68.26","R53.1","O99.345","NO DATA","F32.9"],"date":["2022-06-06","2023-01-25","2023-01-07","2021-09-13","2022-05-19","2022-05-19","2023-01-07","2023-02-01","2022-06-04","2022-06-04","2022-06-04","2022-06-04","2023-01-07","2022-06-04","2022-06-04","2022-06-08","2022-06-04","2023-01-07","2022-06-04","2022-06-04","2023-01-25","2023-01-25","2023-01-25","2022-04-18","2023-01-09","2023-01-07","2021-02-14","2022-05-06","2023-01-07","2023-01-07","2023-01-09","2023-01-07","2023-01-07","2023-01-07","2023-01-07","2023-01-07","2023-01-07","2023-01-07","2022-06-08","2022-06-08","2023-01-09"],"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":[["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","00143980305","DOXYCYCL HYC","CAP 100MG","14","Select","Select",""],["","68462086301","CHLORPROMAZ","TAB 50MG","90","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","40","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","00832712315","DIVALPROEX","TAB 250MG DR","90","Select","Select",""],["","68462086301","CHLORPROMAZINE HCL","50 MG","90","Select","Select",""],["","60505265301","TRAZODONE HCL","50 MG","30","Select","Select",""],["","00832712315","DIVALPROEX SODIUM","250 MG","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":""}]}]}