{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOSHUA C CAUDELL","gend":0,"add":"424 NAVAL BASE ROAD","city":"NORFOLK","state":"VA","zip":"23505-9998","dob":"1982-01-19","age":"","mstatus":"","insh":"900034296*01","cliId":"","pno":"757\/485-0558","cno":"","email":"","ename":"","eno":"","pphy":"HEALTH CENTER, COLISEUM MD","ppno":"757\/827-0420","pcpadd":"3000 COLISEUM DR #200","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":23666,"pcpcounty":"","pcpid":"","pcpname":"SENTARA MEDICAL GROUP","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","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":["J34.3","J34.2","J31.0","R41.3","R41.840","F84.0","F41.9","F43.10","J30.9","R41.841","G43.709","D33.3","E55.9","G43.009","F31.9","F60.2","E78.00","E83.42","Z00.00","F84.2","D36.10","R09.81","R09.82","J06.9","J34.89","Z23.","H90.41","F90.9","F80.9","G93.89","S66.310A","M20.021","R35.0","E78.1","Z78.9","Z13.89","H93.11","Z86.59","R10.31","R10.9","S61.210D","J01.81","F31.32","R10.84","J01.00","Z20.828","R05.","R07.0","R51.9","Z02.5","S29.012A","M62.830","R20.0","R11.2","R19.7","S61.210A","S50.311A","S80.211A","F84.5","J32.9","Z88.8","M25.441","M79.644","R52.","Z86.39","R42.","V19.9XXA","M20.21","S66.311A","Z91.048","R63.5","J01.90","F90.2","Z20.822"],"date":["2020-01-13","2021-07-14","2018-02-28","2019-03-29","2018-03-29","2020-06-01","2019-03-29","2021-09-21","2021-12-01","2018-12-03","2018-12-03","2021-10-25","2019-06-14","2021-06-25","2019-06-14","2019-06-14","2018-12-11","2018-12-11","2021-06-25","2020-09-03","2019-05-14","2021-07-14","2020-04-01","2019-10-23","2020-01-13","2021-09-21","2021-10-25","2018-04-16","2018-04-16","2018-05-21","2020-02-03","2020-02-11","2021-06-25","2021-06-25","2021-06-25","2021-06-25","2018-12-11","2019-03-29","2018-10-30","2020-06-05","2019-10-10","2019-10-15","2020-02-24","2020-06-08","2020-12-04","2021-04-08","2020-12-04","2020-12-04","2020-12-04","2021-09-21","2018-11-14","2018-02-22","2018-02-22","2020-06-08","2020-06-08","2019-10-01","2019-10-01","2019-10-01","2019-10-01","2019-10-01","2019-10-01","2019-12-06","2019-12-06","2019-12-20","2020-02-18","2018-12-11","2019-10-01","2020-02-03","2020-02-03","2018-08-03","2018-11-14","2019-10-01","2020-06-01","2021-04-11"],"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":[]}]},{"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":[["","68462019005","NAPROXEN ","500MG","180","Select","Select",""],["","00536344238","CEROVITE ADVANCED FORMULA ","ADVANCED","130","Select","Select",""],["","11917007450","MULTIPLE VITAMINS\/IRON ","\/IRON","30","Select","Select",""],["","60505095303","AZELASTINE HYDROCHLORIDE\/FLUTICASONE PROPIONATE ","137-50","-23","Select","Select",""],["","00536404610","MULTI-VITAMINS ","","90","Select","Select",""],["","45802065087","LORATADINE ","10MG","90","Select","Select",""],["","49502010202","EPINEPHRINE ","0.3MG","2","Select","Select",""],["","00591024105","LORAZEPAM ","1MG","30","Select","Select",""],["","66685100100","AMOXICILLIN\/CLAVULANATE POTASSIUM ","875-125","20","Select","Select",""],["","62756052169","SUMATRIPTAN SUCCINATE ","50MG","9","Select","Select",""],["","00761036250","MULTI-VITAMINS\/IRON ","","90","Select","Select",""],["","42806040021","METHYLPREDNISOLONE DOSE PACK ","4MG","-21","Select","Select",""],["","11917019913","MULTIVITAMIN ADULTS ","ADULTS","120","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":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}