{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   NEVETSYELDAH W","gend":0,"add":"AOR MELAS 0852NOSLIW ECURB D","city":"VIRGINIA BEACH","state":"VA","zip":"23456-9998","dob":"1958-05-16","age":"","mstatus":"","insh":"8661210*92","cliId":"","pno":"59\/7576876-5","cno":"757\/955-6786","email":"","ename":"","eno":"","pphy":"SAMUELS, GARFIELD HUE MD","ppno":"757\/518-8823","pcpadd":"4452 CORPORATION LN STE 300","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23462,"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":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G89.4","R07.9","I20.0","J43.9","R94.39","J44.9","E53.8","E51.2","G93.41","E87.1","F10.239","E44.0","M80.80XA","Z20.828","I25.10","F17.210","E87.6","F41.9","D72.829","G89.29","I10.","K76.0","M54.9","I16.0","F10.10","R41.82","R07.89","R41.0","Z57.5","F10.20","Y90.1","B34.9","R06.02","F22.","Z72.0","M19.90","Z11.59","Y90.0","R46.89","R19.7","R50.9","NO DATA","Z95.1","Z20.822","R79.89","I49.3","R00.2","K21.9","R05.","J44.1","J41.0","R03.0","I25.110","F17.200","Z53.29","Z72.89"],"date":["2020-07-20","2021-02-24","2020-02-24","2020-02-24","2020-02-24","2021-10-01","2020-10-01","2020-12-16","2020-12-16","2020-12-23","2020-12-23","2020-12-16","2020-12-16","2020-12-16","2020-12-23","2021-02-24","2020-12-16","2020-12-16","2020-12-16","2020-12-23","2021-02-14","2020-12-16","2020-12-23","2020-12-23","2020-12-19","2020-12-23","2021-01-04","2020-12-21","2020-09-15","2021-03-20","2021-03-20","2020-07-31","2020-09-15","2021-05-10","2020-02-15","2020-04-28","2020-09-04","2021-02-24","2021-02-24","2020-05-12","2020-05-12","2021-02-24","2021-01-04","2021-01-04","2021-01-04","2020-02-23","2021-04-16","2021-01-04","2021-04-16","2020-02-17","2020-05-26","2020-05-26","2020-02-23","2020-02-23","2020-09-03","2021-05-10"],"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":[]},{"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":[["","16714045201","QUETIAPINE","TAB 25MG","30","Select","Select",""],["","00254101196","SUCRALFATE","SUS 1GM\/10ML","400","Select","Select",""],["","58914017014","CARAFATE","SUS 1GM\/10ML","400","Select","Select",""],["","23155051901","ISOSORB","TAB 30MG ER","30","Select","Select",""],["","55111015901","OMEPRAZOLE","CAP 40MG","60","Select","Select",""],["","52817036200","METOPROL","TAB 100MG","30","Select","Select",""],["","43598044828","NICOTINE","DIS 21MG\/24H","28","Select","Select",""],["","10702005601","OXYCODONE","TAB 10MG","60","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","15","Select","Select",""],["","65862018501","CLINDAMYCIN","CAP 150MG","30","Select","Select",""],["","00173086910","ANORO","AER 62.5-25","60","Select","Select",""],["","67877019905","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","31722070190","LOSARTAN","TAB 50MG","60","Select","Select",""],["","31604001281","VITAMIN","TAB 100MG","30","Select","Select",""],["","69315012701","FOLIC","TAB 1000MCG","90","Select","Select",""],["","00904549213","THERA-M","TAB ","30","Select","Select",""],["","16714087603","ATORVASTATIN","TAB 40MG","30","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":""}]}]}