{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  LEAHCIMSILLAW J ","gend":0,"add":"A YVI 349L TPA EV","city":"NEWPORT NEWS","state":"VA","zip":"23607-9998","dob":"1983-02-13","age":"","mstatus":"","insh":"1420210*52","cliId":"","pno":"29\/7571059-0","cno":"","email":"","ename":"","eno":"","pphy":"LORENZO, DAVID L MD","ppno":"757\/380-8709","pcpadd":"4714 MARSHALL AVE","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23607,"pcpcounty":"","pcpid":"","pcpname":"PENINSULA INSTITUTE FOR COMMUNITY HEALTH","plan":"OHP","program":"MEDICAID","lob":"OHCC","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":["R06.00","F25.1","R07.9","S66.911A","S63.501A","F20.9","F33.9","V62.84","F14.10","R42.","M25.531","W22.01XA","Y92.019","R07.89","F29.","K60.3","R58.","R10.32","R10.9","M25.562","R20.2","F25.0","Z68.41","F14.90","F60.2","E66.01","F17.210","J45.909","V62.85","Z79.899","Z91.5","J40.","M79.652","M79.662","M25.571","M79.671","S93.601A","L60.1","F41.1","T43.222A","F32.9","F25.9","Z59.00","R11.10","R03.0","J20.9","S63.591A","R51.","E78.00","Z02.2","E78.5","E66.9","Z68.42","NO DATA","R53.1","I83.812","E11.3293","H35.033","H04.121","H04.122","R52.","T14.91XA","Z87.891","Z56.0","R60.0","H04.123","H52.13","H52.223","R11.14","S93.401A","R44.0","T50.901A","K08.89","J45.20","Z79.891","J20.8","R19.7","Z03.818","T78.40XA","R11.2","L03.115","R45.851","Z20.822","Z04.89"],"date":["2020-01-28","2021-12-29","2021-10-07","2020-05-04","2020-05-04","2020-08-02","2021-08-12","2021-10-09","2021-07-21","2021-11-29","2020-05-04","2020-05-04","2020-05-04","2021-10-07","2020-06-16","2020-05-21","2020-05-21","2020-05-23","2020-05-23","2020-07-29","2020-07-29","2021-11-29","2020-04-22","2021-08-16","2020-04-22","2021-11-29","2021-10-07","2021-10-09","2020-04-22","2021-10-09","2020-04-22","2020-05-01","2020-07-28","2020-07-28","2021-03-29","2021-05-16","2021-05-16","2021-05-16","2021-05-16","2021-10-04","2021-10-09","2021-10-18","2021-10-08","2021-10-18","2021-10-18","2020-01-28","2020-05-04","2020-09-10","2020-09-10","2021-10-04","2021-11-29","2021-02-05","2021-02-05","2021-10-08","2021-11-29","2020-04-11","2020-06-05","2021-07-29","2020-06-05","2020-06-05","2020-11-02","2021-10-01","2021-11-29","2021-10-09","2021-03-29","2021-07-29","2021-07-29","2021-07-29","2021-10-18","2021-05-07","2021-09-11","2021-10-01","2021-10-04","2021-10-04","2020-04-11","2020-05-01","2020-05-01","2020-05-01","2021-01-19","2021-10-18","2020-06-16","2021-06-18","2021-10-09","2021-10-09"],"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":[["","","HALOPER","INJ 50MG\/ML","","Select","Select",""],["","","ATORVASTATIN","TAB 10MG","","Select","Select",""],["","","ESCITALOPRAM","TAB 20MG","","Select","Select",""],["","00832030300","CHLORPROMAZ","TAB 100MG","60","Select","Select",""],["","","BENZTROPINE","TAB 2MG","","Select","Select",""],["","68462010860","TOPIRAMATE","TAB 25MG","60","Select","Select",""],["","","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","20","Select","Select",""],["","","HALOPERIDOL","TAB 5MG","","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","49281042150","FLUZONE","INJ 2021-22","0","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","","ARIPIPRAZOLE","TAB 5MG","","Select","Select",""],["","","TRAZODONE","TAB 50MG","","Select","Select",""],["","","VITAMIN","TAB 1000MG","","Select","Select",""],["","","DAILY-VITE","TAB ","","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","","OMEGA-3-ACID","CAP 1GM","","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":""}]}]}