{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RENADA   D KIGLER","gend":1,"add":"25055 OAK TRL APT D","city":"COURTLAND","state":"VA","zip":"23837-9998","dob":"1980-08-24","age":"","mstatus":"","insh":"900038694*01","cliId":"","pno":"757\/556-0314","cno":"","email":"","ename":"","eno":"","pphy":"MUGAISI, HESED N MD","ppno":"757\/738-1375","pcpadd":"148 BURNETTS WAY STE 107","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23434,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS SUFFOLK PRIMARY CARE","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/934-6935","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.65","I10.","E66.01","K21.00","E55.9","Z91.14","Z79.84","R51.","M79.671","M79.89","M25.50","K21.0","Z00.00","Z71.89","Z13.31","M79.672","Z11.59","M72.2","M25.562","Z68.43","D50.9","R73.9","Z23.","M21.41","M21.42","R51.9","Z12.31","R68.89","E11.10","R11.2","Z79.4","Z79.899","Z68.42","Z12.4","F33.1","K08.89","K21.01","J06.9","M24.571","M24.572","R10.9","R19.7"],"date":["2021-12-13","2021-12-13","2021-12-13","2021-12-13","2021-03-03","2021-11-20","2021-11-20","2020-05-20","2020-07-06","2020-05-14","2020-11-18","2020-05-14","2020-05-20","2020-05-20","2020-05-14","2021-07-26","2021-05-03","2021-07-26","2020-11-18","2021-12-17","2021-12-13","2021-11-20","2021-09-07","2021-09-07","2021-09-07","2021-09-07","2021-09-15","2021-11-19","2021-12-17","2021-12-13","2021-12-13","2021-12-13","2021-12-13","2020-05-20","2020-12-16","2021-05-03","2021-05-03","2020-03-05","2021-07-26","2021-07-26","2021-11-20","2021-11-20"],"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":[["","68180051703","LISINOPRIL                                                            ","40MG","30","Select","Select",""],["","68180071909","AMLODIPINE BESYLATE                                                   ","2.5MG","30","Select","Select",""],["","00527169505","BUTALBITAL\/ACETAMINOPHEN\/CAFFEINE                                     ","","30","Select","Select",""],["","29300012510","MELOXICAM                                                             ","15MG","30","Select","Select",""],["","69452015120","VITAMIN D                                                             ","50000UNT","13","Select","Select",""],["","62175011843","OMEPRAZOLE                                                            ","20MG","30","Select","Select",""],["","53885024510","ONETOUCH ULTRA                                                        ","ULTRA","100","Select","Select",""],["","00378718505","METFORMIN HYDROCHLORIDE                                               ","500MG","60","Select","Select",""],["","53885000810","ONETOUCH DELICA PLUS LANCETS EXTRA FINE 33G                           ","PLUS 33G","100","Select","Select",""],["","53885013610","ONETOUCH DELICA LANCETS EXTRA FINE 33G                                ","LANCETS","-100","Select","Select",""],["","53885044801","ONETOUCH ULTRA 2                                                      ","ULTRA 2","-1","Select","Select",""],["","00904759080","FEROSUL                                                               ","325MG","270","Select","Select",""],["","00006011231","JANUVIA                                                               ","50MG","30","Select","Select",""],["","57599000101","FREESTYLE LIBRE 14 DAY\/SENSOR\/FLASH MONITORING SYSTEM                 ","SENSOR","1","Select","Select",""],["","65862018601","CLINDAMYCIN HYDROCHLORIDE                                             ","300MG","30","Select","Select",""],["","66685100100","AMOXICILLIN\/CLAVULANATE POTASSIUM                                     ","875-125","20","Select","Select",""],["","64380080707","IBUPROFEN                                                             ","800MG","20","Select","Select",""],["","57599000200","FREESTYLE LIBRE 14 DAY\/READER\/FLASH MONITORING SYSTEM                 ","READER","1","Select","Select",""],["","11917009215","FERROUS SULFATE                                                       ","325MG","90","Select","Select",""],["","53885091101","ONETOUCH ULTRA MINI                                                   ","ULT MINI","-1","Select","Select",""],["","53885059501","ONETOUCH DELICA LANCETS FINE 30G                                      ","30G","100","Select","Select",""],["","00378668977","PANTOPRAZOLE SODIUM                                                   ","40MG","30","Select","Select",""],["","65702072910","ACCU-CHEK GUIDE                                                       ","GUIDE","1","Select","Select",""],["","00088222033","LANTUS                                                                ","100\/ML","-20","Select","Select",""],["","08290320109","BD PEN NEEDLE\/SHORT\/ULTRA-FINE\/31G X 8MM                              ","31GX8MM","-100","Select","Select",""],["","00002822259","INSULIN LISPRO KWIKPEN                                                ","100\/ML","18","Select","Select",""],["","00088221905","LANTUS SOLOSTAR                                                       ","100\/ML","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":["",""]}},{"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":""}]}]}