{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDER   L LAWRENCE","gend":1,"add":"801 BOUSH ST STE 302","city":"NORFOLK","state":"VA","zip":"23510-9998","dob":"1956-09-11","age":"","mstatus":"","insh":"900040279*01","cliId":"","pno":"757\/625-6161","cno":"","email":"","ename":"","eno":"","pphy":"WHITEHURST-DOSS, SUE NP","ppno":"757\/446-8920","pcpadd":"SUITE 445 825 FAIRFAX AVE","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23507,"pcpcounty":"","pcpid":"","pcpname":"EVMS Internal Medicine","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/446-7114","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R73.03","H40.1132","I10.","E11.9","Z00.00","M85.80","Z13.31","E78.5","B36.0","Z23.","F41.9","F79.","Z12.31","Z13.0","H25.13","M85.89","R73.09"],"date":["2020-12-21","2021-09-13","2021-09-20","2021-11-10","2020-12-21","2021-09-20","2021-10-11","2021-09-20","2020-09-21","2021-09-20","2021-09-27","2021-09-27","2021-02-01","2020-09-21","2021-09-13","2021-11-03","2021-09-20"],"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":[["","63304062110","ATENOLOL                                                              ","25MG","90","Select","Select",""],["","68382018205","BUSPIRONE HCL                                                         ","15MG","90","Select","Select",""],["","41167016515","SELSUN BLUE                                                           ","1%","325","Select","Select",""],["","42543071290","LEVOCETIRIZINE DIHYDROCHLORIDE                                        ","5MG","30","Select","Select",""],["","17478062512","LATANOPROST                                                           ","0.01%","2","Select","Select",""],["","58160082311","SHINGRIX                                                              ","50\/0.5ML","1","Select","Select",""],["","29300013010","HYDROCHLOROTHIAZIDE                                                   ","12.5MG","90","Select","Select",""],["","65162005703","RALOXIFENE HYDROCHLORIDE                                              ","60MG","90","Select","Select",""],["","45802004064","SELENIUM SULFIDE                                                      ","2.50%","120","Select","Select",""],["","16729000617","SIMVASTATIN                                                           ","40MG","90","Select","Select",""],["","68180098003","LISINOPRIL                                                            ","10MG","90","Select","Select",""],["","62756014202","METFORMIN HYDROCHLORIDE ER                                            ","500MG ER","90","Select","Select",""],["","50383070016","FLUTICASONE PROPIONATE                                                ","50MCG","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":["",""]}},{"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":""}]}]}