{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"D   YMAYENOT ","gend":1,"add":"RKA 675EVA NO","city":"CHESAPEAKE","state":"VA","zip":"23322-9998","dob":"1977-11-04","age":"","mstatus":"","insh":"7047210*20","cliId":"","pno":"57\/7575835-4","cno":"","email":"","ename":"","eno":"","pphy":"GARNER, KELSEY J PA","ppno":"757\/842-4100","pcpadd":"725 VOLVO PKWY","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23320,"pcpcounty":"","pcpid":"","pcpname":"Nowcare Volvo","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":["F90.9","F17.200","R11.0","Z68.25","F90.0","F43.0","D50.0","K50.90","R19.7","R53.83","D50.9","Z20.828","K50.80","F17.210","Z68.27","D64.9","Z51.89","R42.","K50.919","K21.9","L60.8","J06.9","G51.0","I10.","Z88.6","Z88.5","Z88.8","R29.810","S93.401A","M25.562"],"date":["2020-12-17","2020-12-17","2020-12-17","2020-12-17","2021-10-11","2021-10-11","2021-05-10","2020-04-28","2020-04-28","2020-04-28","2020-04-28","2020-11-19","2021-01-20","2020-06-09","2019-02-19","2019-09-28","2019-09-28","2019-09-28","2019-11-01","2019-11-01","2019-05-05","2019-05-27","2019-11-20","2019-11-20","2019-11-20","2019-11-20","2019-11-20","2019-11-20","2019-11-05","2019-01-16"],"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":[["","55111015330","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","59417010510","VYVANSE","CAP 50MG","30","Select","Select",""],["","","NICOTINE","DIS 14MG\/24H","","Select","Select",""],["","","EQ","DIS 14MG\/24H","","Select","Select",""],["","00074055402","HUMIRA","INJ 40\/0.4ML","4","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","64764017530","DEXILANT","CAP 60MG DR","30","Select","Select",""],["","10572010001","PEG-3350","SOL ELECTROL","4000","Select","Select",""],["","","LOPERAMIDE","CAP 2MG","","Select","Select",""],["","","CHANTIX","PAK 0.5& 1MG","","Select","Select",""],["","","KLS","TAB 2MG","","Select","Select",""],["","00054001825","PREDNISONE","TAB 20MG","18","Select","Select",""],["","00023031204","REFRESH","OIN OP","4","Select","Select",""],["","65862044990","VALACYCLOVIR","TAB 1GM","21","Select","Select",""],["","59762045001","COLESTIPOL","TAB 1GM","60","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","11822059043","MUCUS","TAB 60-600MG","36","Select","Select",""],["","69452014320","BENZONATATE","CAP 100MG","60","Select","Select",""],["","63824071316","CEPACOL","LOZ 15-3.6MG","32","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":""}]}]}