{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" NORAASREKA","gend":0,"add":"OB OP354 X","city":"HARTFIELD","state":"VA","zip":23071,"dob":"2003-03-07","age":"","mstatus":"","insh":"3836110*63","cliId":"","pno":"96\/4085714-5","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"276\/688-4331","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23071,"pcpcounty":"","pcpid":"","pcpname":"BLAND COUNTY MEDICAL CLINIC INC","plan":"OHP","program":"Medicaid","lob":"M4","region":"CENTRAL","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":["E10.65","E10.10","Z79.4","Z83.3","E13.10","E10.9","K21.9","R11.2","Z20.828","A41.9","E87.2","F41.9","J30.9","Z23.","Z68.52","Z71.82","Z71.3","R68.89","Z82.49","Z79.899","NO DATA","R73.9","R78.89","R82.90","Z13.220","G44.52","E86.0","E11.9","Z88.0","R10.9","Z91.19","V58.89","M25.572","Z91.14","Z00.00","J30.89","J01.00","M25.571","R09.81","E87.8","L70.0","S93.422A","R73.09","J06.9","Z87.892","Z20.822","E55.9"],"date":["2022-08-04","2021-09-23","2022-08-04","2020-12-19","2021-02-18","2022-08-26","2022-08-26","2021-05-28","2020-12-19","2021-04-22","2021-04-22","2020-08-27","2022-08-26","2022-11-22","2020-10-05","2020-10-05","2020-10-05","2020-12-19","2021-04-22","2021-04-22","2021-04-22","2021-05-28","2021-04-22","2021-04-22","2021-10-01","2021-10-01","2021-02-19","2021-04-22","2020-12-19","2021-02-17","2019-01-02","2019-05-16","2019-05-16","2019-05-17","2019-08-30","2019-08-30","2019-09-20","2019-04-25","2019-09-20","2019-12-17","2019-05-01","2019-04-25","2019-12-16","2019-01-29","2019-12-17","2022-01-27","2022-08-26"],"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":[["","08627001601","DEXCOM","MIS TRANSMIT","1","Select","Select",""],["","66733082259","INSULIN","INJ 100\/ML","15","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00002879959","HUMALOG","INJ 100\/ML","15","Select","Select",""],["","08290320122","BD  PEN NEEDL","MIS 32GX4MM","200","Select","Select",""],["","00904671740","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","53885019401","ONETOUCH","KIT VERIO FL","1","Select","Select",""],["","","OMEPRAZOLE","CAP 10MG","","Select","Select",""],["","33332042110","AFLURIA","INJ 2021-22","0","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","71930001752","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","00002803101","GLUCAGON","KIT 1MG","2","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","30","Select","Select",""],["","56151014701","TRUPLUS","MIS 33G","300","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","10","Select","Select",""],["","00781577626","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","","MUPIROCIN","OIN 0.02","","Select","Select",""],["","08470354001","UNFINE","MIS 32GX4MM","200","Select","Select",""],["","","UNIFINE","MIS 32GX5\/32","","Select","Select",""],["","65628007003","FIRST-OMEPRA","SUS 2MG\/ML","270","Select","Select",""],["","00169706515","GLUCAGEN","INJ HYPOKIT","2","Select","Select",""],["","00904572887","ALLERGY","TAB 10MG","30","Select","Select",""],["","00193288021","KETOSTIX","TES STRIP","200","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","70000038002","ALL","TAB 10MG","30","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","30","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","60","Select","Select",""],["","","CLARITIN","TAB 10MG","","Select","Select",""],["","00067399942","LAMISIL","CRE 0.01","12","Select","Select",""],["","37205094199","ATHLETE","CRE AF","15","Select","Select",""],["","51131020814","ACE","MIS BNDG 4\"","2","Select","Select",""],["","51672208001","TERBINAFINE","CRE 0.01","15","Select","Select",""],["","68180065208","DOXYCYC","CAP 100MG","14","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}