{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  NODNARBSTTAB D ","gend":0,"add":"SAID 6458DAOR DNUC","city":"LANEXA","state":"VA","zip":"23089-9998","dob":"2000-03-04","age":"","mstatus":"","insh":"7295110*83","cliId":"","pno":"89\/4080470-0","cno":"804\/980-0740","email":"","ename":"","eno":"","pphy":"THOMAS, DENNIS L MD","ppno":"804\/932-4388","pcpadd":"1850 POCAHONTAS TRAIL","pcpcity":"QUINTON","pcpstate":"VA","pcpzip":23141,"pcpcounty":"","pcpid":"","pcpname":"","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":["H69.83","H90.A32","H90.A21","H69.91","R42.","D82.1","K21.9","R10.9","H61.22","Z88.1","NO DATA","H04.121","H04.122","F84.0","F80.89","F41.9","F40.10","G47.00","H61.23","H60.312","S60.221A","J06.9","Z96.22","Z00.00","K20.9","R51.","T78.40XA","H69.81","Z01.818","K02.9","H73.20","H92.12","H01.02A","H01.02B"],"date":["2022-11-16","2022-07-18","2021-01-29","2021-03-01","2021-01-29","2021-02-09","2022-07-18","2021-05-24","2022-09-06","2022-07-18","2020-08-07","2021-07-02","2021-07-02","2021-11-17","2021-11-17","2021-11-17","2021-11-17","2021-11-17","2022-11-16","2022-05-03","2022-08-04","2022-10-19","2022-11-16","2020-06-30","2020-08-12","2020-08-12","2020-08-12","2021-03-01","2020-08-11","2020-08-11","2021-06-23","2021-12-10","2021-07-02","2021-07-02"],"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":[["","70436015542","PROMETHAZINE","SOL DM","200","Select","Select",""],["","00904671146","FEXOFENADINE","TAB 180MG","30","Select","Select",""],["","60505036301","OFLOXACIN","DRO 0.3%OTIC","5","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","65862001401","AMOXICILLIN","TAB 500MG","21","Select","Select",""],["","00065064705","TOBRADEX","SUS 0.3-0.1%","5","Select","Select",""],["","45802088830","OMEPRAZOLE","TAB 20MG","30","Select","Select",""],["","24208029505","TOBRA\/DEXAME","SUS 0.3-0.1%","5","Select","Select",""],["","00172572880","FAMOTIDINE","TAB 20MG","7","Select","Select",""],["","43598032675","CIPRO\/DEXA","SUS 0.3-0.1%","8","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","15","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","12","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":""}]}]}