{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AIHTECNARFRUHSPU A  ","gend":1,"add":"AVLYS 1848RD ENECS N","city":"MACHIPONGO","state":"VA","zip":"23405-9998","dob":"1972-05-30","age":"","mstatus":"","insh":"7835210*85","cliId":"","pno":"7675732728","cno":"","email":"","ename":"","eno":"","pphy":"WASHBURN, KELLY MD","ppno":7573311086,"pcpadd":"17068 LANKFORD HWY","pcpcity":"EASTVILLE","pcpstate":"VA","pcpzip":"23347-9998","pcpcounty":"","pcpid":"","pcpname":"EASTERN SHORE RURAL HEALTH SYSTEM INC","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":["N30.01","N95.1","Z79.890","I10.","R74.01","Z82.49","E78.5","R94.31","Z12.31","I34.0","L30.9","E11.9","Z28.21","Z71.3","L20.9","L81.4","K80.20"],"date":["2023-06-14","2023-03-16","2023-03-16","2023-04-17","2023-06-22","2023-04-17","2023-04-17","2023-04-17","2023-03-13","2023-04-17","2023-02-02","2023-02-02","2023-02-02","2023-02-02","2023-03-21","2023-03-21","2023-06-22"],"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":[["","58657067501","CIPROFLOXACIN HCL","250 MG","6","Select","Select",""],["","65862051330","PIOGLITAZONE HCL","30 MG","30","Select","Select",""],["","16714008210","HYDROXYZINE HCL","25 MG","90","Select","Select",""],["","45802006436","TRIAMCINOLONE ACETONIDE","0.1 %","80","Select","Select",""],["","16714017403","ATORVASTATIN CALCIUM","20 MG","90","Select","Select",""],["","00469266030","VEOZAH","45 MG","30","Select","Select",""],["","00555088602","ESTRADIOL","1 MG","30","Select","Select",""],["","00597015230","JARDIANCE","10 MG","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":[]}},{"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":""}]}]}