{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LATISHA JOHNSON","gend":1,"add":"1034 PATRIOT WAY APT 102","city":"PORTSMOUTH","state":"VA","zip":"23707-9998","dob":"1989-12-19","age":"","mstatus":"","insh":"9142479*01","cliId":"","pno":7579772587,"cno":7579772587,"email":"","ename":"","eno":"","pphy":"COOPER JR, JIMMY L NP","ppno":7579779675,"pcpadd":"3001 CHURCHLAND BLVD,","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":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z01.810","R94.31","D64.9","E66.01","Z68.42","M25.532","F43.12","I37.1","I42.9","I49.3","I10.","D57.3","F41.9","Z98.51","Z79.899","Z82.49","Z83.3","Z82.61","Z88.2","Z20.822","S60.212A","R51.9","K21.9","E66.9","Z68.33","Z87.891","V58.89","F43.10","F43.21","R07.2","R00.1","Z02.79","V89.2XXD","M25.571","R07.89","E87.6","R00.2","F41.1","NO DATA","Z86.718","Z98.891","Z98.890","V89.2XXA","R07.9","I25.2","S63.502A","R10.2","R82.90"],"date":["2021-09-29","2022-03-29","2021-08-18","2022-02-08","2022-02-08","2023-01-18","2023-08-11","2021-09-27","2021-09-29","2021-09-29","2022-02-08","2022-08-13","2022-02-08","2022-02-08","2022-08-13","2022-02-08","2022-02-08","2022-02-08","2022-02-08","2022-02-08","2022-08-13","2022-08-13","2022-08-13","2022-08-13","2022-08-13","2022-08-13","2023-01-18","2021-10-26","2021-10-26","2022-03-29","2022-03-29","2022-10-19","2022-11-22","2022-10-19","2022-03-29","2022-09-23","2022-03-29","2022-02-08","2022-02-08","2022-02-08","2022-02-08","2022-02-08","2022-09-01","2022-03-29","2021-08-13","2022-08-18","2022-09-23","2022-09-23"],"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":[["","00781324664","ENOXAPARIN","INJ 40\/0.4ML","6","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","10","Select","Select",""],["","00245531911","KLOR-CON M20","TAB 20MEQ ER","4","Select","Select",""],["","51801001230","EFFER-K","TAB 20MEQ","10","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","49483060350","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","00536132701","ACETAMINOPHE","TAB 325MG","40","Select","Select",""],["","16714020030","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","11845073105","VITAMIN B-1","TAB 500MG","60","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":""}]}]}