{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"IREHSDNIW ","gend":1,"add":"NAHC 4631DAOR AKLE","city":"NORFOLK","state":"VA","zip":"23503-9998","dob":"1986-03-12","age":"","mstatus":"","insh":"7204110*89","cliId":"","pno":"33\/7576650-1","cno":"","email":"","ename":"","eno":"","pphy":"TUCKER, MICHAEL MD","ppno":"757\/625-3777","pcpadd":"110 KINGSLEY LANE SUITE 411","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23505,"pcpcounty":"","pcpid":"","pcpname":"MICHAEL L TUCKER MD FAMILY PRACTICE","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":["F11.20","F90.1","F40.8","Z71.51","J01.10","J02.9","R09.82","Z76.0","L03.211","R21.","L30.9","F90.8","F41.9","L98.9","R07.9"],"date":["2019-02-01","2019-02-01","2019-02-01","2019-02-01","2019-02-23","2019-02-23","2019-02-23","2019-02-23","2021-04-08","2020-03-11","2020-03-06","2019-06-24","2019-06-24","2020-03-04","2020-02-03"],"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":[["","","VYVANSE"," VYVANSE ","30","Select","Select",""],["","","OMEPRAZOLE"," OMEPRAZOLE ","28","Select","Select",""],["","","BUSPIRONE"," BUSPIRONE ","60","Select","Select",""],["","","AMOX\/K"," AMOX\/K ","20","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","20","Select","Select",""],["","","NEO\/POLY\/HC"," NEO\/POLY\/HC ","10","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","","BENZONATATE"," BENZONATATE ","30","Select","Select",""],["","","AMOXICILLIN"," AMOXICILLIN ","30","Select","Select",""],["","","APAP\/CODEINE"," APAP\/CODEINE ","6","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","8","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","14","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","","TRIAMCINOLON","CRE 0.00025","","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","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":""}]}]}