{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  SELRAHCREKLAW G","gend":0,"add":"DOOW N 9471DAOR ESUOH","city":"VIRGINIA BEACH","state":"VA","zip":"23454-9998","dob":"1960-05-07","age":"","mstatus":"","insh":"5162110*61","cliId":"","pno":"7875756360","cno":7578730933,"email":"","ename":"","eno":"","pphy":"PHILLIPS, CHARLES K MD","ppno":7575944111,"pcpadd":"12 BRUTON AVENUE","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":"23601-9998","pcpcounty":"","pcpid":"","pcpname":"Bruton Avenue Family Practice","plan":"OHP","program":"ACA","lob":"Small Group","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":["Z20.822","T84.022A","T84.062A","T84.052A","I10.","E78.2","Z86.718","Z86.19","Z90.49","Z87.891","T84.092A","T84.498A","J32.0","J01.00","R93.0","Z47.1","M17.12","Z96.652","R26.9","Z96.651","G89.18","M25.562","Z23.","L03.211","Z01.818","Z01.810","Z01.812","Z51.81","M25.762","M19.272","R94.31","Z79.899","Z00.00","B18.2","Z12.5","E55.9","Z20.828","T84.098A","Z96.659","T84.498D","R26.89","M25.661","M25.561","Z12.11","L82.1","L81.4","D22.9","I78.1","M62.81","J32.9","R07.9","K21.9","Z96.653","Z56.6","R06.02"],"date":["2021-02-15","2021-02-18","2021-02-18","2021-02-18","2023-06-29","2023-04-24","2023-06-29","2021-02-18","2021-02-18","2023-06-29","2021-02-18","2021-02-18","2022-10-28","2021-05-24","2021-05-24","2022-02-07","2022-02-07","2022-02-07","2022-01-24","2021-12-30","2021-12-31","2021-12-30","2023-04-24","2021-11-30","2021-12-20","2021-12-20","2021-12-20","2021-12-20","2021-12-20","2021-12-20","2021-12-20","2021-12-20","2023-04-28","2023-04-28","2023-04-28","2023-04-28","2021-01-05","2021-12-30","2021-02-18","2021-03-04","2021-03-25","2021-03-25","2021-03-25","2023-04-24","2022-03-28","2022-03-28","2022-03-28","2022-03-28","2021-03-25","2021-05-06","2023-06-29","2023-06-29","2023-06-29","2023-06-29","2023-06-29"],"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":[["","00406012301","HYDROCO\/APAP TAB","5-325MG","30","Select","Select",""],["","00536123441","ASPIRIN LOW TAB","81MG EC","60","Select","Select",""],["","62332014231","CELECOXIB CAP","200MG","30","Select","Select",""],["","59779046708","ASPIRIN LOW CHW","81MG","60","Select","Select",""],["","65862058701","AMLOD\/BENAZP CAP","10-40MG","90","Select","Select",""],["","00378064110","PREDNISONE TAB","10MG","30","Select","Select",""],["","27241012403","SILDENAFIL TAB","20MG","90","Select","Select",""],["","42571025101","CLINDAMYCIN CAP","150MG","63","Select","Select",""],["","72578005505","DOXYCYCL HYC CAP","100MG","20","Select","Select",""],["","00093342210","CYCLOBENZAPRINE HCL","10 MG","30","Select","Select",""],["","00378064110","PREDNISONE","10 MG","42","Select","Select",""],["","16714063403","OMEPRAZOLE","20 MG","30","Select","Select",""],["","65862058701","AMLODIPINE BESYLATE-BENAZEPRIL","10 MG-40MG","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":""}]}]}