{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" AYOKAHSTEELFRON","gend":1,"add":"ROHETIHW 0366101 TPA RD N","city":"NORFOLK","state":"VA","zip":"23513-9998","dob":"1995-05-07","age":"","mstatus":"","insh":"4498210*42","cliId":"","pno":"83\/7579432-1","cno":"","email":"","ename":"","eno":"","pphy":"BARAKOTI, PRASHANT MD","ppno":"757\/627-6220","pcpadd":"STE 100 400 W BRAMBLETON AVE","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23510,"pcpcounty":"","pcpid":"","pcpname":"VA Beach Internal Medicine","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":["F33.1","O47.1","Z3A.39","O99.52","Z37.0","J45.909","Z88.0","Z20.822","O34.219","Z34.83","R07.9","H60.391","R55.","J30.1","J30.2","H90.41","H60.501","D64.9","Z79.899","H83.8X1","Z32.01","R11.0","Z98.890","Z3A.28","Z23.","O21.9","R10.9","O36.8139","Z3A.38","G89.18","Z39.1","Z34.82","Z87.09","R06.02","H66.001","H92.01","Z39.2","H60.63","L29.9","B36.9","O34.211","R03.0","Z86.19","Z98.891","H90.5","O99.611","K21.9","O26.891","R07.89","Z3A.08","H60.331","Z3A.37","R00.2","NO DATA","G89.29","O26.892","R10.13","Z3A.15","M54.6","L30.4","M54.2","N62.","Z00.00","M62.89","M54.5","O99.02","O80.","R10.84","R73.09","R42.","Z3A.14","O36.8131","J06.9","Z32.02","R19.4","Z71.3","O20.0","O36.8130","Z79.52"],"date":["2021-01-19","2021-09-10","2021-09-11","2021-09-10","2021-09-11","2021-11-23","2021-11-03","2021-09-10","2021-09-10","2021-09-17","2021-11-02","2021-11-03","2021-12-28","2021-11-12","2020-08-31","2021-11-12","2020-12-30","2020-12-30","2020-12-30","2020-12-30","2021-01-14","2021-01-14","2021-01-14","2021-06-29","2021-06-29","2021-07-12","2021-07-12","2021-09-07","2021-09-07","2021-09-11","2021-09-17","2021-09-17","2021-11-02","2021-11-02","2021-11-03","2021-11-03","2020-02-05","2020-09-28","2020-09-28","2020-09-28","2021-09-11","2021-09-11","2020-03-08","2020-03-08","2020-09-28","2021-02-10","2021-02-10","2021-02-10","2021-02-10","2021-02-10","2021-11-12","2021-08-31","2021-11-23","2021-11-23","2021-11-23","2019-07-15","2019-07-15","2019-07-15","2019-04-03","2019-04-03","2019-04-03","2019-04-03","2019-04-04","2019-04-25","2019-04-25","2019-12-29","2019-12-29","2019-02-25","2019-04-10","2019-07-09","2019-07-09","2019-12-18","2019-03-15","2019-03-15","2019-03-18","2019-03-18","2019-05-06","2019-12-19","2019-12-19"],"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":[["","49884018601","DOXYL\/PYRID","TAB 10-10MG","100","Select","Select",""],["","31604002674","D3","TAB 2000UNIT","180","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","","FERROUS","TAB 325MG EC","","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","50428029673","CVS","SUS ANTI-GAS","355","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","00904672040","ACETAMIN","TAB 500MG","60","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00781618667","CIPRO\/DEXA","SUS 0.3-0.1%","8","Select","Select",""],["","51672127406","BETAMETH","CRE 0.0005","45","Select","Select",""],["","00603533828","PREDNISONE","TAB 10MG","30","Select","Select",""],["","70677003402","STOOL","CAP 100MG","30","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","25","Select","Select",""],["","","CORTISPORIN","","","Select","Select",""],["","80681000900","VITAMIN","CAP 50MCG","60","Select","Select",""],["","","NEO\/POLY\/HC","SOL 1% OTIC","","Select","Select",""],["","","HC\/ACET","SOL OTIC","","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","","DOCUSATE","CAP 100MG","","Select","Select",""],["","","LEVOCETIRIZI","TAB 5MG","","Select","Select",""],["","","MOMETASONE","CRE 0.001","","Select","Select",""],["","63044015001","PRENATAL","TAB LOW IRON","30","Select","Select",""],["","58657050016","CODEINE\/GG","SOL 10-100\/5","120","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","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":""}]}]}