{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" NEBUHDAMLETAP B  ","gend":1,"add":"LGAE 8221RD DOOWE","city":"VIRGINIA BEACH","state":"VA","zip":"23454-9998","dob":"1944-01-01","age":"","mstatus":"","insh":"28300210*79","cliId":"","pno":"29\/7578648-7","cno":"","email":"","ename":"","eno":"","pphy":"PATEL, JITENDRA M MD","ppno":"757\/390-4540","pcpadd":"2088 S INDEPENDENCE BLVD STE 101","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23453,"pcpcounty":"","pcpid":"","pcpname":"BAYVIEW PHYSICIAN SERVICES PC","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":["K59.01","R14.0","R10.13","K21.9","J30.9","R93.89","I10.","E78.2","E74.39","E55.9","E03.9","D64.9","N39.0","F32.5","H60.92","T78.40XA","R10.9","F32.9","R77.1","H60.543","H90.3","E11.9","J20.9","H35.363","H04.123","M77.11","M25.521","R60.0","R05.","U07.1","E66.9","Z68.32","R10.10","Z00.00","R42.","H69.83","M51.36","M54.16","R07.9","M19.90","NO DATA","G89.29","M17.0","M25.561","M25.562","M79.604","M79.605","M47.817","M46.1","G43.119","M25.512"],"date":["2020-06-11","2020-06-11","2020-06-11","2022-09-02","2022-02-25","2021-09-09","2022-09-02","2022-09-02","2022-09-02","2022-02-25","2022-02-25","2021-09-09","2022-06-02","2022-02-25","2020-01-25","2020-05-19","2020-05-19","2020-05-19","2021-01-15","2021-02-15","2021-02-15","2021-09-23","2020-02-28","2020-09-24","2020-09-24","2021-04-23","2021-04-23","2021-04-23","2021-09-23","2021-09-23","2021-09-23","2021-09-23","2020-02-21","2019-01-23","2022-09-30","2019-09-08","2022-05-18","2022-11-09","2022-05-18","2022-07-08","2022-07-08","2022-07-08","2022-03-04","2022-02-25","2022-11-09","2022-02-25","2022-02-25","2022-11-09","2022-11-09","2022-09-30","2022-11-09"],"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":[["","64380073706","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","53885013610","ONETOUCH","MIS LANCETS","100","Select","Select",""],["","","AMLODIPINE","TAB 5MG","","Select","Select",""],["","42385090410","METFORMIN","TAB 500MG","30","Select","Select",""],["","00781107810","ATENOLOL","TAB 25MG","30","Select","Select",""],["","","ESCITALOPRAM","TAB 5MG","","Select","Select",""],["","31722072610","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","58602000640","OLOPATADINE","DRO 0.001","5","Select","Select",""],["","65862056090","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","16714068403","SIMVASTATIN","TAB 40MG","30","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","500","Select","Select",""],["","16714017303","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","16","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","65162019011","NAPROXEN","TAB 500MG","60","Select","Select",""],["","50228017910","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","16103038711","MECLIZINE","CHW 25MG","30","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","30","Select","Select",""],["","","FLUZONE","INJ PF 20-21","","Select","Select",""],["","00065427325","PAZEO","DRO 0.007","2","Select","Select",""],["","00065081604","PATADAY","SOL 0.007","2","Select","Select",""],["","61314064511","NEO\/POLY\/HC","SUS 1% OTIC","10","Select","Select",""],["","42571012290","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","","BENZONATATE","CAP 100MG","","Select","Select",""],["","","MUCUS","TAB 30-600ER","","Select","Select",""],["","","OSELTAMIVIR","CAP 75MG","","Select","Select",""],["","","HYD","SUS 10-8\/5ML","","Select","Select",""],["","","LISINOPRIL","TAB 10MG","","Select","Select",""],["","","DICYCLOMINE","CAP 10MG","","Select","Select",""],["","","FAMOTIDINE","TAB 40MG","","Select","Select",""],["","","ESOMEPRA","CAP 40MG DR","","Select","Select",""],["","","CIMETIDINE","TAB 400MG","","Select","Select",""],["","00193731150","CONTOUR","TES NEXT","100","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","49281071910","FLUBLOK","INJ 2019-20","0","Select","Select",""],["","61570003150","CORTISPORIN","OIN 0.01","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":""}]}]}