{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAIKNEKA  N BROWN","gend":1,"add":"25506 ZION ROAD APT B1","city":"RUTHER GLEN","state":"VA","zip":"22546-9998","dob":"1988-10-31","age":"","mstatus":"","insh":"8991278*01","cliId":"","pno":8048678515,"cno":8048678515,"email":"","ename":"","eno":"","pphy":"TANKERSLEY, CAROLYN J NP","ppno":8044435378,"pcpadd":"1362 TAPPAHANNOCK BLVD,","pcpcity":"TAPPAHANNOCK","pcpstate":"VA","pcpzip":"22560-9998","pcpcounty":"","pcpid":"","pcpname":"Tappahannock Primary Care","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8044439667,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N64.4","R56.9","F17.200","Z79.899","Z23.","M25.572","R30.0","Z32.01","Z11.3","Z32.02","R51.9","R03.0","R10.9","J06.9","R50.9","F32.9","F19.10","R10.31","M77.8","I10.","Z20.822","Z11.52","G44.89","R52.","N39.0","G40.909","F12.90","E66.9","Z76.89","Z11.59","Z68.32","F33.2","F14.20","F12.20","R05.9","N92.1","Z01.419","F17.210","R90.82","S43.402A","S20.212A"],"date":["2021-07-27","2022-07-27","2022-04-06","2021-07-27","2022-12-10","2023-04-07","2021-12-23","2021-12-23","2021-12-23","2021-12-23","2022-04-06","2022-04-06","2022-04-06","2022-11-11","2022-11-07","2021-02-16","2021-02-16","2021-02-16","2021-02-16","2022-04-06","2021-06-01","2021-06-01","2022-04-06","2022-04-06","2022-04-06","2022-10-11","2022-10-11","2022-10-11","2022-10-11","2022-10-11","2022-10-11","2021-02-23","2021-02-23","2021-02-23","2022-11-11","2023-05-16","2022-09-19","2022-07-27","2022-07-27","2023-03-10","2023-03-10"],"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":[["","68180012202","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","00548570100","MEDROXYPR AC","INJ 150MG\/ML","1","Select","Select",""],["","69097012403","TOPIRAMATE","100 MG","90","Select","Select",""],["","31722063231","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","00536121388","MUCUS RELIEF","TAB 60-1200","30","Select","Select",""],["","00548570100","MEDROXYPROGESTERONE ACETATE","150 MG\/ML","1","Select","Select",""],["","49483060350","IBUPROFEN","600 MG","20","Select","Select",""],["","00548570100","MEDROXYPR AC INJ","150MG\/ML","1","Select","Select",""],["","68180012202","CEPHALEXIN CAP","500MG","28","Select","Select",""],["","65862017360","TOPIRAMATE TAB","100MG","30","Select","Select",""],["","00536121388","MUCUS RELIEF TAB","60-1200","30","Select","Select",""],["","31722063231","OSELTAMIVIR CAP","75MG","10","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":""}]}]}