{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   LATSYRKNIATRAS D","gend":1,"add":"2 W 334TS HT7","city":"NORFOLK","state":"VA","zip":"23517-9998","dob":"1985-11-09","age":"","mstatus":"","insh":"0567210*93","cliId":"","pno":"35\/7574071-7","cno":"757\/264-1974","email":"","ename":"","eno":"","pphy":"VILLATE PRIETO, SUSANA MD","ppno":"757\/278-2240","pcpadd":"155 KINGSLEY LN STE 400","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23505,"pcpcounty":"","pcpid":"","pcpname":"DEPAUL MEDICAL ASSOCIATES","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":["E11.9","Z79.4","D64.9","R53.83","M79.671","B37.0","Z68.36","E11.3411","E11.3412","E11.3511","H43.391","H47.10","H04.123","E11.3413","I10.","E55.9","N62.","G47.00","E78.00","N76.0","B00.9","F41.9","F43.22","G56.03","B96.89","E11.3512","M79.604","M25.561","E11.319","M79.605","G89.29","H43.11","E11.3513","G45.3","J06.9","R39.15","R10.2","J32.4","N76.1","B37.3","Z12.4","E11.3293","E11.3213","K21.9","D22.9","J30.9","Z68.35","R00.2","R00.0","M54.89","J40.","F43.10","H93.8X2","Z11.59","R09.81","NO DATA","Z79.84","R42.","H65.02","J02.0","E11.21","Z91.89","R05.","K52.9","Z98.51","M79.644","J34.89","R10.32","J02.9"],"date":["2021-03-17","2021-12-02","2020-12-02","2020-01-15","2021-09-17","2020-07-08","2020-02-18","2021-03-08","2021-05-04","2021-12-13","2021-08-10","2020-06-25","2021-03-08","2021-04-06","2021-12-02","2020-10-29","2020-10-29","2020-10-29","2021-03-17","2021-03-17","2021-03-17","2021-09-17","2021-03-17","2021-03-17","2021-03-17","2021-12-13","2021-09-17","2021-09-17","2021-12-02","2021-09-17","2021-09-17","2021-12-13","2021-07-07","2021-09-20","2021-11-22","2020-02-18","2020-02-18","2020-02-18","2020-02-18","2020-02-18","2020-02-18","2020-06-19","2020-06-19","2020-01-28","2020-01-28","2020-01-28","2020-06-30","2020-06-30","2020-06-30","2020-09-05","2021-12-02","2021-12-02","2021-12-02","2021-12-02","2019-01-03","2019-02-18","2019-01-15","2019-08-08","2019-08-02","2019-08-02","2019-02-18","2019-02-18","2019-04-16","2019-10-28","2019-07-24","2019-07-24","2019-01-22","2019-12-23","2019-08-28"],"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":[["","00002143480","TRULICITY","INJ 1.5\/0.5","2","Select","Select",""],["","","FERROUS","TAB 325MG EC","","Select","Select",""],["","47781057073","LIDOCAINE","CRE 0.04","50","Select","Select",""],["","","LANTUS","INJ 100\/ML","","Select","Select",""],["","56151014701","TRUPLUS","MIS 33G","100","Select","Select",""],["","","BD  PEN NEEDL","MIS 32GX5\/32","","Select","Select",""],["","00006057561","JANUMET","TAB 50-500MG","60","Select","Select",""],["","","ATORVASTATIN","TAB 40MG","","Select","Select",""],["","","CONTOUR","TES NEXT","","Select","Select",""],["","47781055301","LABETALOL","TAB 200MG","60","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00093727298","PIOGLITAZONE","TAB 30MG","30","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00904582460","VITAMIN","TAB 1000UNIT","30","Select","Select",""],["","00597015230","JARDIANCE","TAB 10MG","30","Select","Select",""],["","","NYSTATIN","SUS 100000","","Select","Select",""],["","42806016005","HYDROXYZ","TAB 25MG","30","Select","Select",""],["","00093077198","PRAVASTATIN","TAB 10MG","90","Select","Select",""],["","68462010340","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","68462074635","ACYCLOVIR","OIN 0.05","15","Select","Select",""],["","","MICROLET","MIS LANCETS","","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","00093227534","AMOX\/K","TAB 875-125","20","Select","Select",""],["","","CVS","CAP 1000UNIT","","Select","Select",""],["","","CLOTRIMAZOLE","TRO 10MG","","Select","Select",""],["","","TRIAMCINOLON","OIN 0.001","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","31604002683","D3","TAB 1000UNIT","30","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","45","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","50","Select","Select",""],["","","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","","BAYER","MIS LANCETS","","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","69097082112","GEMFIBROZIL","TAB 600MG","60","Select","Select",""],["","23155019101","BUPROPION","TAB 75MG","60","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","15","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":""}]}]}