{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   LORACREPRAH A","gend":1,"add":"SDOOW 107DAOR KCOT","city":"VIRGINIA BEACH","state":"VA","zip":"23464-9998","dob":"1947-05-15","age":"","mstatus":"","insh":"68200210*94","cliId":"","pno":"25\/7576241-3","cno":"","email":"","ename":"","eno":"","pphy":"BONEY, ARON MD","ppno":"757\/278-2240","pcpadd":"155 KINGSLEY LN STE 400","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23505,"pcpcounty":"","pcpid":"","pcpname":"DEPAUL MEDICAL ASSOCIATES","plan":"OHP","program":"MEDICAID","lob":"OHCC","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":["E78.5","I25.10","I11.9","Z68.25","K22.10","J43.9","E86.0","C50.811","NO DATA","I12.9","D50.9","E78.2","K44.9","F17.210","Z17.1","K21.9","Z95.1","Z79.82","Z90.13","Z79.811","R13.10","I21.4","I10.","I25.708","Z68.24","R80.9","N25.81","J44.9","I70.8","Z20.828","Z90.49","Z85.3","Z90.710","Z98.82","F17.200","Z17.0","I16.9","I25.110","I77.1","M85.80","K92.1","Z79.899","Z98.61","H04.123","H25.013","K27.9","C50.919","Z71.9","Z95.5","M65.311","N18.3","F17.218","Z12.11","I42.0","R07.9","Z76.89","G89.29","H53.453","H02.831","H02.834","N17.9","Z01.818","N65.0","C50.411","D64.9","L30.9","Z23.","D50.8","R10.31","N64.4","C50.911","R07.89","R10.9","M54.9","L57.0","L30.8","L82.1","N18.4","I08.8","E83.52","R10.13","R10.32","I25.2","Z79.02","R11.0","M53.3","Z00.00","Z11.59","Z68.23","Z03.818","Z20.822","I13.0","I50.32","R00.1"],"date":["2022-06-10","2022-06-10","2020-08-12","2021-12-29","2020-11-07","2020-11-07","2020-11-09","2022-04-20","2022-06-10","2022-09-20","2022-03-23","2021-09-24","2020-12-09","2022-06-10","2020-11-07","2022-06-10","2022-06-07","2022-06-10","2022-06-10","2020-12-08","2020-11-09","2022-06-07","2022-04-25","2022-06-07","2022-04-25","2022-09-20","2022-09-20","2022-06-10","2020-12-09","2020-12-09","2020-12-08","2022-06-10","2020-12-08","2020-12-08","2022-03-23","2022-04-20","2020-12-09","2020-12-10","2020-12-09","2022-06-10","2020-12-09","2022-06-10","2020-12-24","2021-02-11","2021-02-11","2021-01-06","2020-02-20","2021-01-04","2022-06-10","2020-06-19","2020-09-08","2020-09-08","2020-09-08","2020-12-09","2022-05-26","2021-12-29","2022-03-23","2019-03-13","2019-03-13","2019-03-13","2019-01-21","2019-08-12","2019-08-22","2019-10-16","2019-08-27","2019-10-04","2019-11-19","2019-10-16","2019-07-05","2019-07-30","2019-11-19","2022-06-01","2022-06-01","2022-03-23","2022-03-23","2022-03-23","2022-03-23","2022-09-20","2022-05-26","2022-04-20","2022-06-10","2022-06-10","2022-06-10","2022-06-10","2022-06-23","2022-03-14","2022-04-25","2022-04-25","2022-05-26","2022-02-07","2022-02-07","2022-05-27","2022-05-27","2022-06-10"],"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":[["","65862035790","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","72511076002","REPATHA","INJ 140MG\/ML","2","Select","Select",""],["","","LOVASTATIN"," LOVASTATIN ","30","Select","Select",""],["","80777028299","MODERNA","INJ BA4\/BA5","0","Select","Select",""],["","","METOPROL"," METOPROL ","30","Select","Select",""],["","","CVS"," CVS ","60","Select","Select",""],["","62559016701","OXYCODONE","CAP HCL 5MG","30","Select","Select",""],["","","LETROZOLE"," LETROZOLE ","10","Select","Select",""],["","00168000615","TRIAMCINOLON","OIN 0.001","30","Select","Select",""],["","65162006205","SUCRALFATE","SUS 1GM\/10ML","420","Select","Select",""],["","69097081312","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","00536104710","SODIUM","TAB 650MG","180","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","49281012165","FLUZONE","INJ 2021-22","1","Select","Select",""],["","49483048112","ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","00378518693","PRASUGREL","TAB 10MG","30","Select","Select",""],["","70377002811","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","15","Select","Select",""],["","","SHINGRIX","INJ 50\/0.5ML","","Select","Select",""],["","","FLUAD","INJ 0.5ML","","Select","Select",""],["","","BOOSTRIX","INJ ","","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":""}]}]}