{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   NNAOJLLEBSA E","gend":1,"add":"LLOH 732TS YADA","city":"SUFFOLK","state":"VA","zip":"23434-9998","dob":"1961-02-04","age":"","mstatus":"","insh":"5517110*89","cliId":"","pno":"73\/7578498-3","cno":"757\/373-8948","email":"","ename":"","eno":"","pphy":"GARNER, BARBARA NP","ppno":"804\/693-4410","pcpadd":"7685 MEREDITH DRIVE","pcpcity":"GLOUCESTER","pcpstate":"VA","pcpzip":23061,"pcpcounty":"","pcpid":"","pcpname":"TPMG OBGYN AND GYNECOLOGY","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":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J01.90","J06.9","Z68.29","R07.9","L20.89","L82.0","F43.20","F33.9","F43.10","R20.2","R42.","H53.8","R51.9","L28.0","L08.9","B00.1","R51.","J34.89","F43.9","J30.1","Z68.28","S83.242A","E86.0","H00.012","H04.123","L21.8","U07.1","J20.8","M25.561","M17.11","M25.562","G43.009","R21.","N89.8","R63.2","E66.3","R10.84","K52.9","K21.9","R14.0","R52.","R11.11","D23.5","D23.62","D23.61","L29.8","L53.8","R26.89","H25.13","H25.011","M23.204","M17.12","H25.813","H10.45","H52.03","H10.9","S93.601A","S93.602A","S70.02XA","M25.572","K51.90","Z87.891","Z88.5","R20.0","S05.02XA"],"date":["2020-02-20","2020-02-20","2020-02-20","2021-06-10","2020-03-19","2022-01-12","2021-03-19","2021-03-19","2021-03-19","2021-10-26","2021-10-26","2021-10-26","2021-10-26","2022-01-12","2022-01-12","2022-01-12","2020-02-04","2020-02-04","2020-02-04","2020-03-05","2020-02-04","2020-02-11","2021-10-26","2020-07-31","2022-06-29","2020-09-10","2022-06-01","2022-06-01","2022-11-03","2022-11-03","2022-11-03","2020-02-01","2020-03-05","2020-03-05","2020-03-05","2020-03-05","2020-08-18","2021-07-08","2021-07-08","2021-07-08","2020-02-01","2020-02-01","2020-03-25","2020-03-25","2020-03-25","2020-03-25","2020-03-25","2020-07-03","2020-09-10","2020-09-10","2020-11-20","2020-11-20","2022-06-29","2022-06-29","2022-06-29","2022-11-15","2020-07-03","2020-07-03","2020-07-03","2020-07-03","2021-10-26","2021-10-26","2021-10-26","2021-10-26","2022-09-02"],"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":[]},{"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":[["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","54629041120","VITAMIN","TAB 2000UNIT","30","Select","Select",""],["","10702000201","PROMETHAZINE","TAB 12.5MG","24","Select","Select",""],["","68180065208","DOXYCYC","CAP 100MG","20","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","51672125903","CLOBETASOL","OIN 0.0005","60","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","65862044930","VALACYCLOVIR","TAB 1GM","4","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","Select","Select",""],["","65862075705","OLOPATADINE","DRO 0.001","5","Select","Select",""],["","10572010101","PEG-3350","SOL ELECTROL","4000","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","3","Select","Select",""],["","49035045875","ALLERGY","TAB 10MG","30","Select","Select",""],["","70748021416","MESALAMINE","CAP 0.375GM","120","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","4","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","31604004071","D3","TAB 2000UNIT","30","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","90","Select","Select",""],["","29033000305","SUCRALFATE","TAB 1GM","120","Select","Select",""],["","11877001140","BINAXNOW","KIT HOME TES","4","Select","Select",""],["","64980051505","OFLOXACIN","DRO 0.3% OP","5","Select","Select",""],["","60505083305","AZELASTINE","SPR 0.001","30","Select","Select",""],["","61314062810","POLYMYXIN","SOL TRIMETHP","10","Select","Select",""],["","61314063705","PREDNISOLONE","SUS 1% OP","5","Select","Select",""],["","65862053750","LEVOFLOXACIN","TAB 500MG","7","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","23359010030","CENTRATEX","CAP ","30","Select","Select",""],["","00378870006","ACYCLOVIR","OIN 0.05","15","Select","Select",""],["","29300011716","TOPIRAMATE","TAB 100MG","30","Select","Select",""],["","65162046510","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","45802043262","PSEUDOEPHEDR","TAB 30MG","30","Select","Select",""],["","45802043803","HYDROCORT","CRE 0.01","28","Select","Select",""],["","62332036371","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","63824000832","MUCINEX","TAB 600MG ER","14","Select","Select",""],["","45802006435","TRIAMCINOLON","CRE 0.001","45","Select","Select",""],["","00093506105","HYDROXYZ","TAB 25MG","60","Select","Select",""],["","65162062710","TRAMADOL","TAB 50MG","15","Select","Select",""],["","00065924007","DUREZOL","EMU 0.0005","5","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":""}]}]}