{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ALRACNEERG","gend":1,"add":"IC 0061RD ELCR","city":"PETERSBURG","state":"VA","zip":"23803-9998","dob":"1990-02-17","age":"","mstatus":"","insh":"98400210*67","cliId":"","pno":"15\/4089343-9","cno":"","email":"","ename":"","eno":"","pphy":"MOSCHLER JR, EDWARD F MD","ppno":"757\/741-6033","pcpadd":"4221 CROSSINGS BLVD","pcpcity":"PRINCE GEORGE","pcpstate":"VA","pcpzip":23875,"pcpcounty":"","pcpid":"","pcpname":"SOUTHSIDE PHYSICIANS NETWORK - OB\/GYN","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","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":["D64.9","N93.8","F17.200","O36.5930","O99.824","Z3A.37","Z37.0","I49.9","R55.","R07.89","V23.9","O99.332","Z3A.24","O36.5921","Z20.822","O36.5990","O99.893","R94.31","R00.1","R06.00","R06.02","R07.9","M79.89","O16.3","Z3A.33","I49.2","Z3A.26","Z3A.34","O99.214","Z37.9","Z3A.00","N92.1","D62.","D50.0","D57.3","F17.210","R93.89","Z71.6","Z82.49","Z83.3","Z34.83","Z3A.36","N76.4","Z33.1","R51.9","Z3A.01","Z32.01","Z3A.32","K21.9","E66.9","R42.","R10.30","J96.01","J18.9","R07.1","E66.01","A41.9","D57.00","J18.1","R07.81","J90.","Z68.41","D50.9","H91.92","R73.02","R48.0","Z91.013","Z79.899","Z83.2","H66.92","H60.92","H92.02","N93.9","R65.10","M54.5","Z00.00","N91.1","Z72.0","K08.89"],"date":["2020-01-13","2020-01-13","2020-01-13","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-11","2021-11-11","2021-11-11","2021-11-01","2021-11-01","2021-08-02","2021-08-02","2021-11-01","2021-11-01","2021-11-12","2021-11-12","2021-11-12","2021-11-12","2021-11-12","2021-11-12","2021-11-12","2021-10-06","2021-10-06","2021-11-12","2021-08-16","2021-10-11","2021-11-02","2021-11-02","2021-11-02","2020-01-12","2020-01-12","2020-01-12","2020-01-12","2020-01-12","2020-01-12","2020-01-12","2020-01-12","2020-01-12","2021-10-27","2021-10-27","2021-10-27","2021-10-27","2021-06-03","2021-06-03","2021-03-31","2021-09-27","2019-04-26","2019-04-22","2019-03-26","2019-03-26","2019-04-26","2019-04-27","2019-04-26","2019-04-27","2019-04-22","2019-04-22","2019-04-22","2019-04-23","2019-04-22","2019-04-22","2019-04-22","2019-04-22","2019-04-22","2019-04-22","2019-04-22","2019-04-22","2019-04-22","2019-02-28","2019-02-28","2019-02-28","2019-03-30","2019-04-22","2019-03-06","2019-03-06","2019-03-06","2019-04-24","2019-07-25"],"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":[["","68180012202","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","11917009215","FERROUS","TAB 325MG","100","Select","Select",""],["","50428027137","CVS","TAB 27-0.8MG","90","Select","Select",""],["","45802048678","DOCUSATE","CAP 100MG","60","Select","Select",""],["","49483060350","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","60","Select","Select",""],["","31722072320","LEVOFLOXACIN","TAB 750MG","5","Select","Select",""],["","59762374202","MEDROXYPR","TAB 10MG","60","Select","Select",""],["","68180030320","CEFUROXIME","TAB 500MG","10","Select","Select",""],["","11917013938","VITAMIN","TAB 500MG","60","Select","Select",""],["","24208063110","NEO\/POLY\/HC","SOL 1% OTIC","10","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","60","Select","Select",""],["","45802086802","POLYETH","POW 3350 NF","952","Select","Select",""],["","00363010412","PAIN","TAB 325MG","100","Select","Select",""],["","10337040030","FLORA-Q","CAP ","10","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","57237004105","PENICILLN","TAB 500MG","28","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","16","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":""}]}]}