{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  AIBHSOTRETRAC R ","gend":1,"add":"EBLIG W 142B TPA TS TR","city":"HAMPTON","state":"VA","zip":"23669-9998","dob":"1975-03-28","age":"","mstatus":"","insh":"3022210*74","cliId":"","pno":"73\/7579641-2","cno":"","email":"","ename":"","eno":"","pphy":"SHAH, MEGHANA R MD","ppno":"757\/673-5890","pcpadd":"5818 HARBOUR VIEW BLVD STE 250","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23435,"pcpcounty":"","pcpid":"","pcpname":"HARBOUR VIEW FAMILY PRACTICE","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":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J45.50","R06.00","E66.01","U07.1","Z68.36","E11.9","J45.51","Z68.35","F33.1","M79.3","J06.9","K43.9","D50.0","H04.123","S39.012A","J45.909","Z79.899","M54.5","R05.1","R50.9","J02.9","Z91.048","Z91.010","Z87.09","R09.81","E11.00","F41.9","Z86.010","E55.9","D50.8","R79.89","NO DATA","Z86.39","Z20.822","M25.561","R07.0","F41.0","R10.2","S80.01XA","Z91.018","Z91.09","Z79.84","Z79.51","R20.2","E78.00","Z79.1","M79.2","M21.6X1","M21.6X2","M24.572","M24.571"],"date":["2021-02-05","2021-02-05","2021-02-05","2021-12-27","2021-02-05","2022-07-16","2022-03-30","2021-12-01","2021-09-05","2021-08-20","2020-01-31","2021-03-30","2021-05-19","2020-12-15","2020-12-17","2022-07-16","2022-07-16","2020-12-17","2021-12-27","2021-12-27","2021-12-27","2022-07-16","2021-12-27","2021-12-27","2021-12-27","2021-12-01","2022-03-30","2021-12-01","2022-03-30","2021-12-01","2021-12-01","2022-03-30","2022-03-30","2022-05-18","2022-08-01","2022-03-30","2022-03-30","2022-06-10","2022-07-15","2022-07-16","2022-07-09","2022-07-16","2022-07-16","2022-07-09","2022-07-16","2022-07-16","2022-07-14","2022-07-14","2022-07-14","2022-07-14","2022-07-14"],"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":[["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","30","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","68382018005","BUSPIRONE","TAB 5MG","60","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","","METFORMIN","TAB 500MG","","Select","Select",""],["","70377002811","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA","100","Select","Select",""],["","","LOSARTAN","TAB 25MG","","Select","Select",""],["","","DULOXETINE","CAP 30MG","","Select","Select",""],["","","GLIPIZIDE","TAB 5MG","","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","56151146001","TRUE","TES GLUCOSE","100","Select","Select",""],["","64380071207","BENZONATATE","CAP 100MG","30","Select","Select",""],["","","IBUPROFEN","TAB 600MG","","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","74","Select","Select",""],["","00115169449","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","08271036100","LANCETS","MIS THIN","100","Select","Select",""],["","00245010810","FERROUS","TAB 325MG EC","90","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","15","Select","Select",""],["","65702071110","ACCU-CHEK","TES GUIDE","50","Select","Select",""],["","59779082589","CVS","TAB 60-600MG","18","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","","FLOVENT","AER 220MCG","","Select","Select",""],["","","JANUVIA","TAB 100MG","","Select","Select",""],["","","OLOPATADINE","SOL 0.002","","Select","Select",""],["","","TRADJENTA","TAB 5MG","","Select","Select",""],["","","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","","LIDOCAINE","SOL 2% VISC","","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":""}]}]}