{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NYL   NORAHSNOSNHOJ ETTE","gend":1,"add":"2 8421TS DN2","city":"NEWPORT NEWS","state":"VA","zip":"23607-9998","dob":"1960-09-05","age":"","mstatus":"","insh":"2007110*59","cliId":"","pno":"23\/7574378-7","cno":"757\/327-8734","email":"","ename":"","eno":"","pphy":"LORENZO, DAVID L MD","ppno":"757\/380-8709","pcpadd":"4714 MARSHALL AVE","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23607,"pcpcounty":"","pcpid":"","pcpname":"PENINSULA INSTITUTE FOR COMMUNITY HEALTH","plan":"OHP","program":"ACA","lob":"Individual","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":["H25.813","H04.123","H53.021","H25.012","H25.042","I10.","Z21.","Z87.891","Z79.899","H25.011","H25.041","E78.00","B20.","Z00.00","Z01.419","Z12.31","M20.41","M79.671","L84.","M21.6X2","H25.812","H25.811","H53.001","Z96.1","Z12.39","R39.15","N32.81","Z12.11","R19.5","K63.5","B16.2","Z13.1","Z86.010","D12.8","D12.5","B18.2","Z68.22","H53.009","B19.20","J20.9","R50.9","R93.5","Z68.20","Z92.29","R05.","R07.81","Z23."],"date":["2021-10-05","2021-10-05","2021-10-05","2021-08-04","2021-08-04","2022-03-07","2021-09-28","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2022-03-07","2022-03-07","2021-06-28","2021-06-28","2022-02-21","2021-05-03","2021-05-03","2021-05-03","2021-05-03","2021-08-04","2021-09-08","2021-09-08","2021-09-08","2021-11-08","2021-02-01","2021-07-06","2021-07-06","2019-11-02","2019-11-02","2019-10-07","2020-05-18","2019-11-02","2019-11-02","2019-11-02","2020-04-30","2019-10-07","2020-08-06","2019-10-14","2019-11-05","2019-11-05","2019-10-14","2020-01-28","2019-01-14","2019-11-05","2019-11-05","2020-09-21"],"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":[["","15584010101","ATRIPLA","TAB ","30","Select","Select",""],["","61958180101","HARVONI","TAB 90-400MG","28","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","8","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","12","Select","Select",""],["","72626260101","LEDIP-SOFOSB","TAB 90-400MG","28","Select","Select",""],["","00536404610","MULTI-VITAMN","TAB ","90","Select","Select",""],["","61314035501","TROPICAMIDE","SOL 1% OP","3","Select","Select",""],["","58160089652","FLUARIX","INJ 2019-20","0","Select","Select",""],["","00143314250","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","42192060716","BROM\/PSE\/DM","SYP ","150","Select","Select",""],["","61958220101","EPCLUSA","TAB 400-100","28","Select","Select",""],["","49702024213","JULUCA","TAB 50-25MG","-30","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","31604001489","VITAMIN","TAB 1000MG","90","Select","Select",""],["","00093720210","PRAVASTATIN","TAB 40MG","90","Select","Select",""],["","00093523456","EFAVIR\/EMTRI","TAB TENOFOVI","-30","Select","Select",""],["","00093001006","TOLTERODINE","TAB 1MG","60","Select","Select",""],["","17478071310","OFLOXACIN","DRO 0.3% OP","5","Select","Select",""],["","60758011905","PREDNISOLONE","SUS 1% OP","10","Select","Select",""],["","61314012605","KETOROLAC","SOL 0.005","10","Select","Select",""],["","49281072110","FLUBLOK","INJ 2021-22","0","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","31722070090","LOSARTAN","TAB 25MG","30","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}