{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  ALLEDNOVYROGERG S ","gend":1,"add":"LOH 1202TC SNIL","city":"CHESAPEAKE","state":"VA","zip":"23320-9998","dob":"1978-10-30","age":"","mstatus":"","insh":"7779710*15","cliId":"","pno":"7975789041","cno":7578256200,"email":"","ename":"","eno":"","pphy":"GRIFFIN, ALESIA W MD","ppno":7573660692,"pcpadd":"1413 KEMPSVILLE RD","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":"23320-9998","pcpcounty":"","pcpid":"","pcpname":"ALESIA W GRIFFIN MD PC","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":["F41.0","Z62.898","M79.602","M79.605","D25.1","R10.2","F32.0","L03.012","M54.9","M79.662","I10.","R10.31","D25.9","B34.9","Z20.822","R19.7","D25.2","N83.9","Z00.00","Z01.419","R68.83","R11.2","E66.9","Z68.36","D25.0","N92.0","R14.0","D64.9","N94.10","N85.2","Z79.899","Z12.31","D72.829","M54.16","N92.5","Z12.39","L02.416","M77.11","M70.032","M79.89"],"date":["2021-09-03","2021-09-03","2021-03-09","2021-11-09","2021-11-02","2021-07-26","2021-09-03","2022-06-15","2021-07-26","2021-11-17","2022-08-08","2021-03-22","2021-12-02","2022-01-15","2022-01-15","2022-01-15","2021-06-07","2021-06-07","2021-11-09","2021-11-09","2021-03-22","2021-03-22","2021-03-22","2021-03-22","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2022-07-23","2022-02-07","2022-02-07","2021-11-02","2021-06-11","2021-10-25","2021-10-25","2021-10-25","2022-06-15"],"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":[["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","65862001905","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","00713022580","TRIAMCINOLON","CRE 0.001","80","Select","Select",""],["","57237004290","VALACYCLOVIR","TAB 500MG","30","Select","Select",""],["","69238126601","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","69238110005","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","00603533932","PREDNISONE","TAB 20MG","21","Select","Select",""],["","00121077504","GG\/CODEINE","SOL 100-10\/5","118","Select","Select",""],["","70010075405","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","30","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","23155050201","HYDROXYZ","TAB 50MG","14","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","61314063705","PREDNISOLONE","SUS 1% OP","10","Select","Select",""],["","65862046890","LOSARTAN\/HCT","TAB 50-12.5","90","Select","Select",""],["","61314062810","POLYMYXIN","SOL TRIMETHP","10","Select","Select",""],["","45802048526","FLUOCIN","OIL 0.01% SC","118","Select","Select",""],["","00713052612","PROMETHEGAN","SUP 25MG","10","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","6","Select","Select",""],["","45802058084","SCOPOLAMINE","DIS 1MG\/3DAY","1","Select","Select",""],["","65162010250","GABAPENTIN","CAP 300MG","14","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","12","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":""}]}]}