{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"W YECATSSMAILLI","gend":1,"add":"CIUQ 0811NL ENOZ K","city":"BEDFORD","state":"VA","zip":"24523-9998","dob":"1989-02-14","age":"","mstatus":"","insh":"05500210*00","cliId":"","pno":"53\/7575218-4","cno":"757\/354-8125","email":"","ename":"","eno":"","pphy":"PHILLIPS, CHARLES K MD","ppno":"757\/594-4111","pcpadd":"12 BRUTON AVENUE","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23601,"pcpcounty":"","pcpid":"","pcpname":"Bruton Avenue Family Practice","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"","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":["F41.1","F31.81","F43.10","F84.0","F31.9","J30.1","R19.7","Z20.822","R26.2","M54.5","M54.6","M54.2","M79.673","G93.5","R73.9","J01.01","M25.572","M79.671","M79.672","M76.821","M24.575","M24.574","M12.872","M53.3","N92.6","E28.2","N92.0","N94.5","E66.9","M20.5X2","M20.5X1","N32.81","R10.32","K59.00","K58.2","M54.9","R35.8","Z20.828","Z03.818","NO DATA","R43.0","G89.29","E55.9","N39.46","R39.15"],"date":["2022-10-25","2020-12-17","2022-10-25","2022-10-25","2022-10-25","2021-04-22","2021-04-22","2021-04-22","2020-01-28","2021-07-22","2020-04-17","2021-07-22","2020-01-28","2021-10-07","2022-03-02","2021-11-18","2020-06-17","2020-06-17","2020-06-17","2020-06-17","2020-06-17","2020-06-17","2020-06-17","2021-07-22","2020-01-07","2020-01-07","2020-01-07","2020-01-07","2020-01-07","2020-01-08","2020-01-08","2020-11-04","2020-04-17","2020-07-21","2020-05-05","2021-05-03","2020-05-05","2020-11-23","2020-11-23","2021-05-03","2021-04-26","2021-05-03","2021-09-01","2020-01-02","2020-01-02"],"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":[["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","270","Select","Select",""],["","53885013610","ONETOUCH","MIS LANCETS","100","Select","Select",""],["","00591565810","CYCLOBENZAPR","TAB 10MG","60","Select","Select",""],["","45802057178","FEXOFENADINE","TAB 180MG","90","Select","Select",""],["","31604002509","VITAMIN","CAP 500MG","90","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","30","Select","Select",""],["","00093770198","LEVOCETIRIZI","TAB 5MG","90","Select","Select",""],["","42806016005","HYDROXYZ","TAB 25MG","90","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","15","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00115169449","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","00115174501","METAXALONE","TAB 400MG","28","Select","Select",""],["","00527155201","BUT\/ASA\/CAFF","CAP ","30","Select","Select",""],["","45802048678","DOCUSATE","CAP 100MG","60","Select","Select",""],["","68382025501","OXYBUTYNIN","TAB 5MG ER","30","Select","Select",""],["","45802086866","POLYETH","POW 3350 NF","30","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","28","Select","Select",""],["","00093031101","LOPERAMIDE","CAP 2MG","30","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","00469260130","MYRBETRIQ","TAB 25MG","30","Select","Select",""],["","53885004401","ONE","KIT VERIO FL","1","Select","Select",""],["","58160084252","BOOSTRIX","INJ ","0","Select","Select",""],["","43199001101","HYOSCYAMINE","SUB 0.125MG","60","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","20","Select","Select",""],["","43386035801","HYDROCO\/APAP","TAB 10-325MG","15","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","50428033623","CHEWABLE","CHW ROSE HIP","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":""}]}]}