{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" NAVARNELLUM","gend":1,"add":"AEL KAO 312A TPA TC F","city":"CHESAPEAKE","state":"VA","zip":"23320-9998","dob":"1999-07-27","age":"","mstatus":"","insh":"9740810*44","cliId":"","pno":"15\/7571201-3","cno":"757\/513-1021","email":"","ename":"","eno":"","pphy":"MOUZON, NAKESHIA L NP","ppno":"757\/204-1901","pcpadd":"1216 GRANBY ST STE 20","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23510,"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":["O85.","J18.9","E43.","Z68.1","D50.9","E55.9","L29.2","N76.0","Z11.3","Z30.09","R10.2","R63.0","F50.00","A74.9","A54.01","B37.3","R11.2","Z32.01","O36.5930","Z3A.34","O34.211","Z37.0","Z3A.37","R51.9","Z20.822","M79.651","Z30.8","A41.9","D64.9","Z3A.29","Z3A.36","O26.893","R10.84","O76.","Z79.899","D50.0","Z37.9","Z30.42","R10.32","Z3A.32","Z3A.35","Z39.2","Z13.32","O36.5920","Z36.89","Z3A.28","Z3A.33","O34.32","Z87.51","V23.9","V23.5","Z3A.27","M54.30","H10.011","O34.219","Z3A.19","Z3A.20","O36.5993","Z3A.31","O71.00","O75.9","K66.1","O21.9","O34.30","O99.322","F12.90","R63.6","M54.89","Z39.1","Z34.82","Z34.83"],"date":["2020-01-11","2020-01-14","2020-01-14","2020-01-11","2020-01-11","2020-01-14","2020-05-06","2020-10-22","2020-10-22","2020-05-06","2020-08-27","2021-01-16","2021-01-16","2020-05-13","2020-05-13","2020-10-22","2021-07-19","2021-07-19","2022-02-05","2022-01-17","2022-02-05","2022-02-05","2022-02-05","2022-08-22","2022-08-22","2022-08-22","2022-09-23","2020-01-14","2020-01-14","2021-12-09","2022-01-31","2022-02-05","2022-02-05","2022-02-05","2022-02-05","2020-01-12","2020-01-12","2022-06-28","2020-08-27","2021-12-30","2022-01-24","2022-03-14","2022-03-14","2021-12-06","2021-12-06","2021-12-06","2022-01-10","2021-11-24","2021-10-07","2021-11-24","2021-11-24","2021-11-24","2022-02-22","2020-08-09","2021-10-06","2021-10-06","2021-10-07","2021-12-09","2021-12-27","2022-02-05","2022-02-05","2022-02-05","2021-07-05","2021-10-06","2021-10-06","2021-10-06","2021-10-06","2021-12-31","2022-01-14","2022-01-14","2022-01-14"],"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":[["","66689002316","HYDROCO\/APAP","SOL 7.5-325","118","Select","Select",""],["","45802095243","IBUPROFEN","SUS 100\/5ML","147","Select","Select",""],["","59762453701","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","00603150858","PHENOBARB","ELX 20MG\/5ML","60","Select","Select",""],["","64679096401","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","68462030201","INDOMETHACIN","CAP 50MG","2","Select","Select",""],["","65162006205","SUCRALFATE","SUS 1GM\/10ML","420","Select","Select",""],["","59762500901","CLINDAMYCIN","CRE 2% VAG","40","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","65862053750","LEVOFLOXACIN","TAB 500MG","4","Select","Select",""],["","31604002766","PRENATAL","","60","Select","Select",""],["","45802013970","METRONIDAZOL","GEL 0.75%VAG","70","Select","Select",""],["","51672128902","NYSTATIN","CRE 100000","30","Select","Select",""],["","51672130406","TERCONAZOLE","CRE 0.004","45","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN OP","4","Select","Select",""],["","68462010340","FLUCONAZOLE","TAB 150MG","1","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":""}]}]}