{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" REHTAEHXOC N  ","gend":1,"add":"EDLE 7111EUNEVA R","city":"CHESAPEAKE                    ","state":"VA","zip":"23325-3013","dob":"1994-12-26","age":"","mstatus":"","insh":"4186722","cliId":"","pno":"5375772312","cno":"","email":"","ename":"","eno":"","pphy":"PARAGAS, FLORENCE","ppno":7574245778,"pcpadd":"1200 S Military Hwy,Ste 101","pcpcity":"Chesapeake                    ","pcpstate":"VA","pcpzip":233202251,"pcpcounty":"","pcpid":"","pcpname":"PRIMARY CARE PHYSICIANS FOR HAMPTON ROADS","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"TIDEWATER","aligned":"","ano":"","add2":"1117 ELDER AVENUE","add3":"","madd1":"1117 ELDER AVENUE","madd2":"","madd3":"","mcity":"CHESAPEAKE                    ","mstate":"VA","mzip":"23325-3013","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K04.7","N91.2","R51","F41.9","F32.0","Z20.822","B34.9","R53.83","I10","E66.9","G47.33","M25.50","R53.1","D64.9","E03.9","E78.00","R42","E11.65","Z20.828","J18.9","R94.5","R63.5","E28.2","Z68.44","N92.6","R03.0","G47.10","G47.50","E66.01","J45.909","U07.1","R06.02","J12.82","E86.0","R09.02","R50.9","R05.9","R00.0","I51.7","R91.8","R59.0","J98.11","Z93.0","Z46.59","J96.90","J96.01","J98.4","G93.41","I47.2","Z68.43","E66.2","K29.70","I49.3","I27.20","K76.0","D75.1","J96.00","Z45.2","J45.998","R70.1","R60.9","I08.1","R00.1","K56.7","R41.0"],"date":["2020-05-16","2020-08-31","2020-08-31","2021-10-19","2020-08-31","2021-10-19","2021-02-08","2021-05-03","2022-01-13","2021-05-19","2022-03-29","2021-05-03","2021-05-05","2021-05-05","2021-05-05","2021-05-05","2021-05-05","2021-05-05","2022-01-24","2022-03-27","2021-05-19","2021-07-12","2021-06-29","2021-06-29","2021-06-29","2021-06-29","2021-09-17","2021-09-17","2021-11-09","2021-11-09","2021-11-09","2021-10-28","2021-11-09","2021-11-09","2021-11-09","2021-11-04","2021-10-19","2022-02-03","2021-10-19","2021-10-28","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2021-11-09","2021-10-28","2021-10-19","2022-01-13","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2021-10-20","2021-10-25","2021-10-28","2021-11-02","2021-11-02","2022-01-13","2022-02-03","2021-10-20","2021-11-04","2021-11-04"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","31722070090","LOSARTAN","TAB 25MG","15.00","Select","Select",""],["","10006073038","MAG","TAB 400MG","30.00","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","15","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.50","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","24208039830","IPRATROPIUM","SPR 0.0003","30","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","00069108530","PAXLOVID","TAB 300-100","30","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","65162068090","PROMETHAZINE","SOL DM","120","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","20","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","00378021610","FUROSEMIDE","TAB 40MG","90","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","15","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":""}]}]}