{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ANITSIRKZURC M  ","gend":1,"add":"DHCTIW N 401A TPA DR KCU","city":"VIRGINIA BEACH","state":"VA","zip":"23462-9998","dob":"1991-05-15","age":"","mstatus":"","insh":"8681110*61","cliId":"","pno":"28\/7579033-2","cno":"","email":"","ename":"","eno":"","pphy":"KUMAR, ANITA C MD","ppno":"757\/528-2761","pcpadd":"4867 BAXTER RD STE 105","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23462,"pcpcounty":"","pcpid":"","pcpname":"TPMG BEACH PRIMARY CARE","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":["R30.9","G43.909","Z87.891","Z88.8","Z91.018","R42.","M25.561","M25.562","R21.","M54.5","V49.40XA","Y92.410","Y93.89","R87.612","Z32.02","R35.0","N89.8","R63.8","J20.9","R03.0","Z68.34","E78.1","R22.1","J30.1","J30.2","J30.5","J02.9","R10.2","J45.909","R07.9","R87.610","R87.810","Z11.3","Z01.419","Z12.39","Z86.19","J45.20","Z68.33","R09.81","J34.2","R09.82","J30.9","J34.89","L29.8","R07.0","NO DATA","H04.123","H52.13","M25.512","M54.2","Z53.21","Z00.00","E66.9","K76.0","L29.3","B37.3","R51.9","R06.02","R30.0","Z68.31","R59.0","O42.913","O41.03X0","Z37.0","O24.420","O73.0","O69.81X0","Z3A.31","Z23.","Z79.899","Z83.3","Z82.49","Z34.83","O42.113","O24.419","Z3A.32","Z39.1","J45.901","O26.891","K21.9","R10.9","Z3A.01","F41.1","R05.","R07.89","Z04.3","R10.84","G89.11","W18.2XXA","Y92.9","Y93.E1","N91.5","B34.9","Z68.30","O9A.211","O99.89","Z3A.13","Z39.2","A08.4","Z3A.30","O60.03","O26.892","Z3A.20","O62.2","O36.8130","Z3A.29","O26.90","Y92.009","Z3A.18","O26.893","R09.89","Z3A.26","M54.6","M54.42","N30.00","Z20.2","M54.41","G89.29","Z3A.00","O99.212","Z71.3","Z3A.33"],"date":["2020-10-19","2021-12-11","2021-12-11","2021-12-11","2021-12-11","2021-12-11","2020-05-21","2020-05-21","2021-07-30","2020-01-10","2020-01-10","2020-01-10","2020-01-10","2020-07-21","2020-07-21","2021-12-20","2021-12-20","2021-12-20","2020-03-09","2020-03-17","2020-03-17","2020-09-10","2021-02-19","2021-06-01","2021-06-01","2021-04-14","2021-08-07","2020-04-01","2020-07-03","2021-12-15","2020-07-06","2020-07-06","2020-10-19","2020-10-19","2020-10-19","2020-12-22","2020-12-22","2020-12-22","2021-03-26","2021-03-26","2021-03-26","2021-03-26","2021-03-26","2021-03-26","2021-03-26","2020-05-22","2021-03-15","2021-03-15","2020-01-10","2020-01-10","2020-01-10","2020-01-27","2020-01-27","2020-01-27","2021-10-18","2021-10-18","2021-04-24","2021-04-24","2019-02-07","2019-02-07","2019-07-29","2019-09-14","2019-09-03","2019-09-15","2019-09-03","2019-09-03","2019-09-03","2019-09-07","2019-09-03","2019-09-03","2019-09-03","2019-09-03","2019-09-03","2019-09-15","2019-09-15","2019-09-14","2019-09-19","2019-11-06","2019-04-27","2019-03-16","2019-03-16","2019-03-16","2019-06-07","2019-04-01","2019-04-01","2019-04-27","2019-04-27","2019-04-27","2019-04-27","2019-04-27","2019-04-27","2019-02-22","2019-02-15","2019-02-15","2019-04-27","2019-04-27","2019-04-29","2019-10-18","2019-11-19","2019-08-29","2019-09-02","2019-06-20","2019-06-20","2019-08-19","2019-08-19","2019-08-19","2019-09-02","2019-04-29","2019-06-06","2019-07-27","2019-07-27","2019-07-27","2019-01-15","2019-01-15","2019-01-15","2019-01-15","2019-01-15","2019-01-15","2019-02-25","2019-06-03","2019-06-03","2019-09-15"],"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":[["","65862055990","PANTOPRAZOLE","TAB 20MG","30","Select","Select",""],["","","TRICARE","TAB PRENATAL","","Select","Select",""],["","49502010202","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","6","Select","Select",""],["","70700010916","CLOBETASOL","CRE 0.0005","30","Select","Select",""],["","","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","60258019309","PRENATABS","TAB ","90","Select","Select",""],["","63044015005","PRENATAL","TAB LOW IRON","30","Select","Select",""],["","68462010630","ONDANSETRON","TAB 8MG","60","Select","Select",""],["","00527169505","BUT\/APAP\/CAF","TAB ","20","Select","Select",""],["","00781707787","METRONIDAZOL","GEL 0.75%VAG","70","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","51672130406","TERCONAZOLE","CRE 0.004","45","Select","Select",""],["","55111012701","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","53885065701","ONETOUCH","KIT VERIO","1","Select","Select",""],["","69543025810","PREPLUS","TAB 27-1MG","30","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","65162003311","APAP\/CODEINE","TAB 300-30MG","6","Select","Select",""],["","65862001705","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","","AMOX\/K","TAB 500-125","","Select","Select",""],["","","NITROFURANTN","CAP 100MG","","Select","Select",""],["","","VENTOLIN","AER ","","Select","Select",""],["","","BP","MIS DLUX ARM","","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","76204020025","ALBUTEROL","NEB 0.00083","150","Select","Select",""],["","00173072020","FLOVENT","AER 220MCG","12","Select","Select",""],["","64380080307","RANITIDINE","TAB 150MG","30","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","30","Select","Select",""],["","65862001105","SERTRALINE","TAB 25MG","30","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","00904645780","DOK","CAP 100MG","30","Select","Select",""],["","00904585652","CALCIUM","TAB 600MG","60","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":""}]}]}