{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHERYL   S PARHAM","gend":1,"add":"619 43RD ST","city":"NEWPORT NEWS","state":"VA","zip":"23607-9998","dob":"1963-08-24","age":"","mstatus":"","insh":"900046171*01","cliId":"","pno":"757\/713-3708","cno":"","email":"","ename":"","eno":"","pphy":"GREEN-RHODEN, ROSALIND NP","ppno":"757\/930-0091","pcpadd":"12715 WARWICK BOULEVARD M O","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23606,"pcpcounty":"","pcpid":"","pcpname":"Commonwealth Family Practice","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/269-4406","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H40.1131","E11.8","Z00.00","E78.2","H04.123","E11.9","E78.5","J45.909","I10.","K21.9","Z23.","Z79.84","Z87.891","J45.30","M79.641","M79.671","E11.3293"],"date":["2021-11-16","2021-09-15","2021-09-15","2021-09-15","2021-10-27","2021-11-16","2021-11-16","2021-11-16","2021-11-16","2021-11-16","2021-09-15","2021-09-15","2021-09-15","2021-09-15","2021-09-15","2021-09-15","2021-08-19"],"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":[["","00023320503","LUMIGAN                                                               ","0.01%","2","Select","Select",""],["","60432026415","FLUTICASONE PROPIONATE                                                ","50MCG","16","Select","Select",""],["","00065427325","PAZEO                                                                 ","0.70%","-8","Select","Select",""],["","65862019105","CYCLOBENZAPRINE HYDROCHLORIDE                                         ","10MG","30","Select","Select",""],["","53885001110","ONETOUCH DELICA PLUS LANCETS FINE 30G                                 ","PLUS 30G","100","Select","Select",""],["","67877056105","METFORMIN HYDROCHLORIDE                                               ","500MG","60","Select","Select",""],["","53885027150","ONETOUCH VERIO TEST STRIPS                                            ","VERIO","100","Select","Select",""],["","68180021709","LOSARTAN POTASSIUM\/HYDROCHLOROTHIAZIDE                                ","100-25","90","Select","Select",""],["","57237001760","DULOXETINE HYDROCHLORIDE                                              ","20MG","90","Select","Select",""],["","00093720198","PRAVASTATIN SODIUM                                                    ","20MG","90","Select","Select",""],["","68382091601","METHYLPREDNISOLONE                                                    ","4MG","21","Select","Select",""],["","55111064501","OMEPRAZOLE                                                            ","40MG","90","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA                                                 ","HFA","8","Select","Select",""],["","00085461001","DULERA                                                                ","200-5MCG","-13","Select","Select",""],["","65862086001","FAMOTIDINE                                                            ","40MG","90","Select","Select",""],["","68382005101","MELOXICAM                                                             ","15MG","30","Select","Select",""],["","58160082311","SHINGRIX                                                              ","50\/0.5ML","1","Select","Select",""],["","00591212779","BRINZOLAMIDE                                                          ","1%","20","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":""}]}]}