{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JUANITA   P COPES","gend":1,"add":"980 OAK FOREST CT","city":"VIRGINIA BEACH","state":"VA","zip":"23464-9998","dob":"1976-10-23","age":"","mstatus":"","insh":"900045869*01","cliId":"","pno":"757\/724-6482","cno":"757\/724-6482","email":"","ename":"","eno":"","pphy":"LORENZO, DAVID L MD","ppno":"757\/380-8709","pcpadd":"4714 MARSHALL AVE","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23607,"pcpcounty":"","pcpid":"","pcpname":"PENINSULA INSTITUTE FOR COMMUNITY HEALTH","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/928-0902","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.16","M54.42","M54.41","G89.29","R29.6","E87.6","K31.84","R11.2","R94.31","R55.","R07.9","I87.2","E87.2","I10.","G35.","R10.9","R05.","I83.893","D64.9","R10.13","E83.42","M54.5","F41.1","J31.0","Z28.21","E03.9","Z12.31","R12.","E55.9","R51.9","D47.2","D72.829","E83.39","E87.4","G93.2","K21.9","I51.7","M19.90","M62.81","R00.1","R14.0","E86.0","F41.9","Z20.822","Z79.899","Z79.82","Z88.5","Z88.8"],"date":["2021-03-29","2021-03-29","2021-03-29","2021-03-29","2021-03-29","2021-09-08","2021-09-10","2021-09-08","2021-04-23","2021-04-23","2021-09-04","2021-06-29","2021-09-08","2021-09-08","2021-09-08","2021-04-24","2021-04-24","2021-06-29","2021-09-04","2021-09-10","2021-09-08","2021-03-23","2021-03-23","2021-03-23","2021-03-23","2021-04-22","2021-03-23","2021-03-23","2021-03-23","2021-03-23","2021-09-04","2021-09-04","2021-09-04","2021-09-04","2021-09-04","2021-09-04","2021-09-04","2021-09-04","2021-09-04","2021-09-04","2021-09-04","2021-04-22","2021-04-22","2021-04-22","2021-04-22","2021-04-22","2021-04-22","2021-04-22"],"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":[["","68382004101","PROMETHAZINE HYDROCHLORIDE                                            ","25MG","45","Select","Select",""],["","55111017915","TIZANIDINE HCL                                                        ","2MG","40","Select","Select",""],["","00603254021","BUTALBITAL\/ACETAMINOPHEN                                              ","50-325MG","60","Select","Select",""],["","00456045701","ARMOUR THYROID                                                        ","15MG","30","Select","Select",""],["","16729013716","CLONAZEPAM                                                            ","1MG","60","Select","Select",""],["","49483060450","IBUPROFEN                                                             ","800MG","30","Select","Select",""],["","65862052405","GABAPENTIN                                                            ","800MG","90","Select","Select",""],["","00536100901","FERROUS SULFATE                                                       ","325MG","90","Select","Select",""],["","00143312601","DICYCLOMINE HYDROCHLORIDE                                             ","10MG","60","Select","Select",""],["","00378803077","LANSOPRAZOLE                                                          ","30MG DR","90","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE                                                ","50MCG","16","Select","Select",""],["","68180072003","AMLODIPINE BESYLATE                                                   ","5MG","90","Select","Select",""],["","53746051101","SPIRONOLACTONE                                                        ","25MG","180","Select","Select",""],["","00527221537","METOLAZONE                                                            ","2.5MG","90","Select","Select",""],["","70436000203","POTASSIUM CHLORIDE ER                                                 ","10MEQ ER","180","Select","Select",""],["","00228212810","CLONIDINE HYDROCHLORIDE                                               ","0.2MG","180","Select","Select",""],["","70377002711","ATORVASTATIN CALCIUM                                                  ","10MG","90","Select","Select",""],["","00378180010","LEVOTHYROXINE SODIUM                                                  ","25MCG","30","Select","Select",""],["","69452015120","VITAMIN D                                                             ","50000UNT","4","Select","Select",""],["","65162006205","SUCRALFATE                                                            ","1GM\/10ML","-1200","Select","Select",""],["","00406052201","OXYCODONE\/ACETAMINOPHEN                                               ","7.5-325","14","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":""}]}]}