{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JACQUELINE   B RUSHING","gend":1,"add":"3619 GARLAND DR","city":"CHESAPEAKE","state":"VA","zip":"23323-9998","dob":"1946-07-10","age":"","mstatus":"","insh":"900044360*01","cliId":"","pno":"757\/714-8595","cno":"","email":"","ename":"","eno":"","pphy":"SUTTON, THADDEUS MD","ppno":"757\/251-2170","pcpadd":"850 ENTERPRISE PARKWAY SUITE 2200","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":23666,"pcpcounty":"","pcpid":"","pcpname":"Riverside Center for Internal & Family Medicine","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/251-2185","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L89.312","R26.81","M48.02","M40.202","M40.14","R60.9","Z99.3","Z74.2","G30.1","F02.81","G89.4","M79.12","Z98.1","Z51.81","Z79.891","I10.","F02.80","M48.061","M40.204","M81.0","E78.01","E55.9","R09.02","R06.4","R06.89","F03.90","M51.36","F03.91","M10.9","F42.9","F33.2","F41.9","F43.10","M47.816","F32.9","M54.9","K21.9","D64.9","Z86.718","Z12.11","M54.2","R06.02","R52.","Z79.01","Z79.82","Z79.899"],"date":["2021-03-21","2021-02-18","2021-11-29","2021-03-21","2021-03-21","2021-02-18","2021-02-18","2021-02-18","2021-08-31","2021-08-31","2021-11-29","2021-11-29","2021-11-29","2021-11-29","2021-11-29","2021-08-16","2021-08-16","2021-08-16","2021-08-16","2021-08-16","2021-03-22","2021-03-22","2021-04-29","2021-04-29","2021-04-29","2021-04-29","2021-08-25","2021-03-21","2021-03-21","2021-03-21","2021-03-21","2021-03-21","2021-07-27","2021-01-19","2021-07-27","2021-05-07","2021-04-29","2021-03-21","2021-04-29","2021-05-23","2021-08-25","2021-04-29","2021-04-29","2021-04-29","2021-04-29","2021-04-29"],"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":[["","68382080501","TRAZODONE HYDROCHLORIDE                                               ","50MG","90","Select","Select",""],["","55111016330","OLANZAPINE                                                            ","2.5MG","90","Select","Select",""],["","67877024201","QUETIAPINE FUMARATE                                                   ","25MG","-180","Select","Select",""],["","65162062710","TRAMADOL HCL                                                          ","50MG","60","Select","Select",""],["","00406831501","MORPHINE SULFATE ER                                                   ","15MG ER","60","Select","Select",""],["","16714063101","ALENDRONATE SODIUM                                                    ","10MG","90","Select","Select",""],["","43547040211","FUROSEMIDE                                                            ","40MG","90","Select","Select",""],["","69097081507","GABAPENTIN                                                            ","400MG","60","Select","Select",""],["","50484001030","SANTYL                                                                ","250\/GM","-30","Select","Select",""],["","57237001830","DULOXETINE HYDROCHLORIDE                                              ","30MG","90","Select","Select",""],["","00527411637","PROPRANOLOL HYDROCHLORIDE ER                                          ","60MG ER","90","Select","Select",""],["","00310196930","MOVANTIK                                                              ","12.5MG","30","Select","Select",""],["","43547027609","DONEPEZIL HCL                                                         ","10MG","90","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":""}]}]}