{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"J   ARIOCNALB ","gend":0,"add":"KCUB 923EVA EOR","city":"HAMPTON","state":"VA","zip":"23664-9998","dob":"1969-05-08","age":"","mstatus":"","insh":"8262210*38","cliId":"","pno":"03\/7577467-3","cno":"757\/303-7647","email":"","ename":"","eno":"","pphy":"WALKER, KEVA FNP","ppno":"757\/380-8709","pcpadd":"4714 MARSHALL AVE","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23607,"pcpcounty":"","pcpid":"","pcpname":"","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":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F43.8","Z00.00","I10.","E78.5","G89.29","M54.42","M19.90","J30.2","K46.9","Z12.11","M54.2","M54.5","F10.20","S39.012A","M51.36","F39.","F32.3","F25.0","K40.31","R06.2","R06.02","K40.91","F31.4","F19.10","M54.31","E78.00","E05.90","K40.90","F10.239","F14.20","F43.22","F17.210","R05.","Z91.5","J45.909","R53.83","R03.0","S39.82XA","F29.","M41.86","M50.321","M50.322","R06.00","Z20.828","Z79.899","G43.909","Z11.59","Z59.01","Z20.822","R44.0","F12.20"],"date":["2020-09-25","2020-04-02","2022-06-27","2021-09-23","2021-09-23","2021-09-23","2021-09-23","2021-09-23","2020-04-02","2021-06-24","2020-06-25","2020-06-25","2022-01-19","2021-01-17","2021-01-17","2022-01-19","2022-01-19","2022-11-16","2020-07-02","2022-06-27","2022-06-27","2020-06-16","2022-09-09","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2020-07-02","2020-10-10","2020-10-10","2020-10-10","2022-06-27","2020-10-10","2020-10-10","2020-10-11","2020-10-11","2020-10-11","2021-01-17","2021-12-15","2020-06-03","2020-06-03","2020-06-03","2022-06-27","2020-08-18","2022-06-27","2021-09-23","2021-06-24","2021-12-15","2021-12-15","2021-12-15","2022-02-03"],"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":[]},{"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":[["","57664051083","MIRTAZAPINE","TAB 7.5MG","30","Select","Select",""],["","00093505998","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","68382013914","TOPIRAMATE","TAB 50MG","30","Select","Select",""],["","43598016405","OLANZAPINE","TAB 5MG","30","Select","Select",""],["","59746017506","PREDNISONE","TAB 20MG","15","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","68180035206","SERTRALINE","TAB 50MG","30","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","43547034150","RISPERIDONE","TAB 1MG","30","Select","Select",""],["","13668011790","LOSARTAN\/HCT","TAB 100-12.5","30","Select","Select",""],["","16714089803","LORATADINE","TAB 10MG","30","Select","Select",""],["","00067611730","ALLERGY","TAB 10MG","30","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","65162046550","IBUPROFEN","TAB 600MG","90","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","30","Select","Select",""],["","68382009205","CARVEDILOL","TAB 3.125MG","60","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","90","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","15","Select","Select",""],["","16714012302","OMEPRAZOLE","CAP 40MG","14","Select","Select",""],["","00904645780","DOK","CAP 100MG","60","Select","Select",""],["","00093227534","AMOX\/K","TAB 875-125","14","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","20","Select","Select",""],["","57896045401","GERI-KOT","TAB 8.6MG","20","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00904672080","ACETAMIN","TAB 500MG","112","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}