{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ELOCINYAM L  ","gend":1,"add":"ERGLHAD 211B TPA EVA N","city":"PORTSMOUTH","state":"VA","zip":"23702-9998","dob":"1982-12-18","age":"","mstatus":"","insh":"3955310*34","cliId":"","pno":"92\/7579153-2","cno":"","email":"","ename":"","eno":"","pphy":"ROSENBERG, DAVID MD","ppno":"757\/393-6363","pcpadd":"664 LINCOLN STREET","pcpcity":"PORTSMOUTH","pcpstate":"VA","pcpzip":23704,"pcpcounty":"","pcpid":"","pcpname":"Hampton Roads Community Health Center","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":["T50.904A","S83.512A","S83.232A","Z68.27","S83.91XA","Z01.810","R55.","N63.0","Z68.21","M17.12","M25.562","M25.462","S83.92XA","M25.572","G89.29","S83.242A","Z68.26","I10.","M25.561","T40.1X1A","E11.9","F17.210","Z30.42","Z32.02","G89.18","M79.671","M17.11","M25.461","S20.219A","S39.012A","G44.309","S90.31XA","S93.601A","V43.52XA","S83.511A","S83.241A","Z30.013","X50.1XXA","Z01.818","F44.89","NO DATA","R92.8"],"date":["2019-05-21","2019-08-30","2019-06-24","2019-05-28","2020-11-25","2021-06-07","2020-03-27","2021-06-30","2021-06-30","2019-05-23","2019-05-23","2019-04-19","2019-04-19","2019-04-19","2021-02-12","2019-08-30","2019-05-23","2020-08-07","2021-04-16","2019-05-22","2019-05-22","2019-05-22","2019-07-16","2019-07-16","2019-08-30","2020-11-25","2021-02-12","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2021-05-17","2021-05-17","2019-06-26","2019-04-16","2019-08-16","2020-03-27","2020-12-30","2021-10-18"],"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":[["","","SERTRALINE"," SERTRALINE ","30","Select","Select",""],["","","SPIRONOLACT"," SPIRONOLACT ","30","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","30","Select","Select",""],["","","BUPROPN"," BUPROPN ","30","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","90","Select","Select",""],["","","TRAZODONE"," TRAZODONE ","30","Select","Select",""],["","","INDAPAMIDE"," INDAPAMIDE ","30","Select","Select",""],["","","ONETOUCH"," ONETOUCH ","50","Select","Select",""],["","","METFORMIN"," METFORMIN ","60","Select","Select",""],["","","GABAPENTIN"," GABAPENTIN ","30","Select","Select",""],["","","MELOXICAM"," MELOXICAM ","30","Select","Select",""],["","","METRONIDAZOL"," METRONIDAZOL ","4","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","20","Select","Select",""],["","","MEDROXYPR"," MEDROXYPR ","1","Select","Select",""],["","","BUSPIRONE"," BUSPIRONE ","60","Select","Select",""],["","","OXYCODONE"," OXYCODONE ","28","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","","METHOCARBAM","TAB 750MG","","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":""}]}]}