{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NAJ HARASIKSWOHCU","gend":1,"add":"RAOBAES 6331A TPA EVA D","city":"CHESAPEAKE","state":"VA","zip":"23324-9998","dob":"1981-12-16","age":"","mstatus":"","insh":"9758110*59","cliId":"","pno":"45\/7578589-3","cno":"","email":"","ename":"","eno":"","pphy":"MAGNO, ELIZABETH MD","ppno":"757\/424-4442","pcpadd":"6632 INDIAN RIVER RD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23464,"pcpcounty":"","pcpid":"","pcpname":"Nowcare Volvo","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":["F90.9","F31.81","F42.9","NO DATA","Z01.818","L98.499","F41.1","R11.10","R11.2","M25.512","R07.89","M25.522","W19.XXXA","V58.89","M79.672","M79.675","N92.1","D50.9","E55.9","L97.522","J40.","Z72.0","F34.1","L03.032","L60.0","G62.9","Z20.822","S93.412A","M25.572","W18.39XA","R50.9","R06.02","B34.9","N92.0","Z68.41","N83.12","D64.9","I10.","F17.210","K21.9","E66.01","F31.9","G47.30","Z79.899","Z98.51","Z90.79","Z90.721","E66.9","F32.9","F43.20","L03.031","L97.512","F17.200","S49.90XA","L97.529","L40.9","Z28.21","Z71.9","J18.9","R60.0","F31.32","F40.11","F51.04","F60.89","F12.20","Z65.8","J06.9","J20.8","G43.909","N73.6","H60.502","S91.102A","R00.0","F31.89","F12.21","G47.00","F41.9","M65.871","Z98.890","G60.9","L85.1","L97.523","H66.90","H60.90","J30.2","H65.23","H92.03","H90.42","H68.013","J30.1","Z00.8","H70.13","H72.01","L20.9","S91.302A","Z13.31","J02.9","Z11.59","G89.4","J04.0","S91.105A","L08.9","M79.89","Z01.419","N93.9"],"date":["2021-11-16","2021-12-08","2021-12-08","2020-08-31","2021-02-26","2020-10-04","2021-12-08","2020-04-16","2020-04-16","2021-07-28","2021-07-17","2021-07-17","2021-07-17","2020-02-07","2020-06-05","2020-07-10","2020-08-14","2021-01-12","2021-01-12","2021-03-01","2021-12-22","2021-12-22","2020-11-25","2021-07-09","2020-05-13","2020-07-01","2021-02-26","2020-01-17","2020-01-22","2020-01-17","2020-04-16","2020-09-01","2020-04-16","2020-08-14","2020-08-14","2020-08-14","2021-01-05","2021-05-12","2021-05-12","2021-01-05","2020-08-14","2020-08-14","2020-08-14","2021-05-12","2020-08-14","2020-08-14","2020-08-14","2021-01-05","2021-01-05","2021-01-07","2021-07-09","2021-07-09","2021-07-17","2021-07-17","2021-08-30","2021-04-15","2020-03-17","2021-04-15","2020-09-01","2020-09-01","2021-05-11","2021-05-11","2021-05-11","2021-05-12","2021-05-11","2021-05-11","2020-03-10","2020-03-10","2020-08-06","2020-08-14","2021-05-26","2020-02-14","2020-04-16","2021-05-12","2021-05-12","2021-05-12","2021-05-12","2021-09-20","2019-04-22","2019-12-30","2019-06-20","2019-06-20","2019-01-23","2019-01-23","2019-03-20","2019-03-20","2019-03-20","2019-03-20","2019-03-20","2019-03-20","2019-01-28","2019-02-20","2019-02-20","2019-02-20","2019-07-31","2019-04-29","2019-10-23","2019-10-23","2019-07-29","2019-10-12","2019-06-15","2019-06-15","2019-08-13","2019-09-11","2019-12-13"],"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":[["","65862052890","VENLAFAXINE","CAP 75MG ER","30","Select","Select",""],["","43547035410","LISINOPRIL","TAB 20MG","60","Select","Select",""],["","00245010811","FERROUS","TAB 325MG EC","60","Select","Select",""],["","29300015001","QUETIAPINE","TAB 200MG","30","Select","Select",""],["","45802096126","CLOBETASOL","SHA 0.0005","118","Select","Select",""],["","68462025401","ROPINIROLE","TAB 0.5MG","30","Select","Select",""],["","00378668977","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","62332003960","LAMOTRIGINE","TAB 150MG","60","Select","Select",""],["","65862016999","ATENOLOL","TAB 50MG","30","Select","Select",""],["","50383002505","OFLOXACIN","DRO 0.3%OTIC","5","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","00781107710","ALPRAZOLAM","TAB 0.5MG","30","Select","Select",""],["","00074055402","HUMIRA","INJ 40\/0.4ML","2","Select","Select",""],["","50228018005","GABAPENTIN","CAP 300MG","60","Select","Select",""],["","13668000701","ZOLPIDEM","TAB 5MG","30","Select","Select",""],["","65162027210","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","20","Select","Select",""],["","42806031250","DOXYCYCL","TAB 100MG","20","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","12","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","20","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","28","Select","Select",""],["","80777027310","MODERNA","INJ COVID-19","0","Select","Select",""],["","42571025101","CLINDAMYCIN","CAP 150MG","30","Select","Select",""],["","57664037708","TRAMADOL","TAB 50MG","20","Select","Select",""],["","43547034450","RISPERIDONE","TAB 4MG","30","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","21","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","14","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","30","Select","Select",""],["","00436067216","DAKINS","SOL 0.00125","473","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","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":""}]}]}