{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LATSYRKRENIEZ ","gend":1,"add":"AH 7173RD WORR","city":"CHESTER","state":"VA","zip":"23831-9998","dob":"1988-04-29","age":"","mstatus":"","insh":"4769110*77","cliId":"","pno":"53\/4082985-0","cno":"","email":"","ename":"","eno":"","pphy":"BURTON, DIANE L NP","ppno":"804\/522-1814","pcpadd":"8201 ATLEE ROAD SUITE A","pcpcity":"MECHANICSVILLE","pcpstate":"VA","pcpzip":23116,"pcpcounty":"","pcpid":"","pcpname":"COMPASS FAMILY MEDICINE","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":["E78.2","F90.0","G62.9","J01.90","F17.200","F31.9","G47.00","NO DATA","E55.9","R05.","E56.9","Z68.38","I49.8","S10.93XA","R55.","R49.0","S19.9XXA","Z78.0","R73.9","Z68.36","Z00.01","E89.41","M19.90","E78.5","M25.562","F39.","R00.1","I49.9","R07.2","Z76.89","F41.9","N95.9","N95.1","M25.50","J06.9","L30.9","L29.8","E66.9","Z79.1","Z79.899","R42."],"date":["2019-12-06","2021-10-14","2019-11-06","2019-12-06","2021-07-02","2021-07-02","2021-07-02","2021-04-02","2021-04-02","2019-02-05","2020-02-07","2020-02-07","2021-12-08","2021-12-08","2021-12-08","2021-12-08","2021-12-08","2019-01-16","2019-01-16","2019-01-16","2019-05-06","2019-05-06","2019-05-06","2021-12-08","2020-09-04","2019-03-04","2019-06-20","2019-06-20","2019-06-20","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2019-01-08","2019-02-12","2019-02-12","2019-08-06","2019-12-06","2019-12-06","2021-12-08"],"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":[["","","GG\/CODEINE"," GG\/CODEINE ","118","Select","Select",""],["","","AMPHET\/DEXTR"," AMPHET\/DEXTR ","60","Select","Select",""],["","","CLOBETASOL"," CLOBETASOL ","118","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","21","Select","Select",""],["","","TRIAMCINOLON"," TRIAMCINOLON ","454","Select","Select",""],["","","BENZONATATE"," BENZONATATE ","15","Select","Select",""],["","","AZITHROMYCIN"," AZITHROMYCIN ","6","Select","Select",""],["","","GABAPENTIN"," GABAPENTIN ","28","Select","Select",""],["","","BUSPIRONE"," BUSPIRONE ","30","Select","Select",""],["","","VITAMIN"," VITAMIN ","4","Select","Select",""],["","","RANITIDINE"," RANITIDINE ","60","Select","Select",""],["","","ROSUVASTATIN"," ROSUVASTATIN ","30","Select","Select",""],["","","ALPRAZOLAM"," ALPRAZOLAM ","14","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","30","Select","Select",""],["","","CITALOPRAM"," CITALOPRAM ","30","Select","Select",""],["","","SM"," SM ","20","Select","Select",""],["","","MUCINEX"," MUCINEX ","20","Select","Select",""],["","","METHYLPRED"," METHYLPRED ","21","Select","Select",""],["","","DOXYCYCL"," DOXYCYCL ","14","Select","Select",""],["","","IBUPROFEN","TAB 600MG","","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":""}]}]}