{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" LLADNEKNOSNHOJ","gend":1,"add":"C NASUS 123RD TNATSNO","city":"VIRGINIA BEACH","state":"VA","zip":"23451-9998","dob":"2003-05-27","age":"","mstatus":"","insh":"0486810*03","cliId":"","pno":"63\/7570225-4","cno":"","email":"","ename":"","eno":"","pphy":"CHOU, KEVIN MD","ppno":"757\/686-3515","pcpadd":"2088 S INDEPENDENCE BLVD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23453,"pcpcounty":"","pcpid":"","pcpname":"Nowcare Princess Anne","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z00.00","Z23.","Z71.3","Z71.82","Z30.09","Z20.828","N76.0","N30.00","Z11.3","B37.3","F33.1","J06.9","B07.0","F32.2","Z00.129","R63.4","R53.83","Z68.52","R05.","R06.02","R51.9","R11.2","S23.41XA","J30.9","J45.30","Z63.79","L70.0","H35.363","L71.8","H04.121","H04.122","R10.31","N39.0","J45.991","J30.1","J01.00"],"date":["2021-07-16","2021-07-16","2021-07-16","2021-07-16","2021-12-14","2021-12-07","2021-09-03","2021-09-03","2021-09-03","2021-09-03","2020-03-05","2021-06-08","2020-01-28","2020-02-03","2020-02-03","2020-02-03","2020-02-03","2020-02-03","2020-12-07","2020-12-07","2020-12-07","2020-12-07","2021-12-07","2020-12-30","2020-12-30","2020-12-30","2019-11-07","2019-02-14","2019-02-14","2019-02-14","2019-02-14","2019-01-28","2019-01-28","2019-05-07","2019-05-07","2019-12-25"],"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":[["","51991081403","AZELASTINE","SPR 0.001","30","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","3","Select","Select",""],["","29300022705","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","6","Select","Select",""],["","59779043262","NASAL","TAB 30MG","28","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","68462030205","INDOMETHACIN","CAP 50MG","20","Select","Select",""],["","00378877035","ESTRADIOL","CRE 0.0001","42","Select","Select",""],["","","FLUOXETINE","CAP 10MG","","Select","Select",""],["","","TRAZODONE","TAB 50MG","","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","","PREDNISONE","TAB 20MG","","Select","Select",""],["","","FLOVENT","AER 110MCG","","Select","Select",""],["","16729017017","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","16729020016","BUSPIRONE","TAB 5MG","60","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","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":""}]}]}