{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" NERUALDNOMLA","gend":1,"add":"ECNIRP 111RD EGROEG ","city":"HAMPTON","state":"VA","zip":"23669-9998","dob":"1989-09-08","age":"","mstatus":"","insh":"27400210*82","cliId":"","pno":"77\/7574917-1","cno":"757\/920-4391","email":"","ename":"","eno":"","pphy":"DWYER, MEENAL D 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":"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":["F31.61","G44.009","E55.9","D50.0","N92.0","E66.9","Z68.34","Z91.5","Z87.59","G89.29","M47.816","NO DATA","V58.89","E66.01","Z68.41","Z79.899","M54.2","F43.12","F31.4","D25.9","N93.9","E28.2","R93.89","E22.1","M54.5","Z68.39","Z79.891","D25.2","Z23.","L30.4","Z87.2","M46.96","F25.0","V62.84","I10.","M79.7","F17.210","Z68.37","M54.40","G56.03","R11.2","R56.9","R51.","M54.6","D50.8","Z11.3","Z87.42","F29.","F41.1","D64.9","E22.9","F32.9","F41.9","D50.9","G43.801","D35.2","Z91.048","H53.149","B35.9","D21.9","F25.9","R79.89","L68.0","R52.","R03.0","J30.1","Z00.00","J34.1","G44.209","R11.0","Z01.419","Z11.51","Z98.890","M54.30","V58.69","Z91.128","B37.2","V62.85","M54.9","R00.0","R21.","N85.2","F31.9"],"date":["2021-02-05","2019-02-11","2020-07-31","2020-02-11","2020-07-31","2021-03-26","2021-03-26","2019-02-11","2019-02-11","2021-09-29","2021-09-29","2021-06-04","2019-11-06","2019-11-06","2019-04-02","2020-05-19","2021-06-04","2019-12-04","2019-12-04","2021-07-05","2021-02-05","2020-10-05","2019-09-10","2021-02-05","2021-09-29","2019-11-06","2019-11-06","2020-12-14","2020-07-31","2020-09-24","2020-09-24","2021-08-11","2020-01-29","2020-01-15","2020-01-15","2021-07-05","2021-07-05","2020-01-15","2020-01-15","2020-01-15","2020-10-05","2020-12-04","2020-04-02","2021-06-04","2020-10-05","2020-08-20","2020-08-20","2019-06-02","2019-11-21","2020-07-13","2020-08-06","2021-03-26","2021-03-26","2021-07-05","2021-07-05","2021-07-05","2021-07-05","2021-07-05","2019-05-24","2020-06-03","2020-06-03","2020-12-14","2019-08-07","2019-11-21","2019-11-21","2020-01-17","2020-02-11","2020-08-06","2021-03-26","2021-03-26","2020-02-17","2020-02-17","2020-05-19","2019-05-17","2019-05-17","2019-05-17","2019-05-17","2019-05-17","2019-05-18","2019-05-18","2019-05-21","2020-07-13","2020-07-13"],"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":[["","","ONDANSETRON"," ONDANSETRON ","60","Select","Select",""],["","","METHOCARBAM","TAB 750MG","","Select","Select",""],["","","TRANEX","TAB 650MG","","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","68382004001","PROMETHAZINE","TAB 12.5MG","20","Select","Select",""],["","00527169505","BUT\/APAP\/CAF","TAB ","20","Select","Select",""],["","","FLUCONAZOLE"," FLUCONAZOLE ","2","Select","Select",""],["","","VITAMIN"," VITAMIN ","4","Select","Select",""],["","","HYDROXYZ","CAP 50MG","","Select","Select",""],["","","RISPERIDONE","TAB 2MG","","Select","Select",""],["","","OMEPRAZOLE","CAP 20MG","","Select","Select",""],["","","GRALISE","TAB 300MG","","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","Select","Select",""],["","","FEROSUL","TAB 325MG","","Select","Select",""],["","","CABERGOLINE","TAB 0.5MG","","Select","Select",""],["","","GABAPENTIN","CAP 300MG","","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":""}]}]}