{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LESTER   ERA TURNER","gend":0,"add":"208 PEAR AVE","city":"HAMPTON","state":"VA","zip":"23661-9998","dob":"1962-08-04","age":"","mstatus":"","insh":"2016627*01","cliId":"","pno":"757\/344-1984","cno":"757\/344-1984","email":"","ename":"","eno":"","pphy":"DELAHOUSSAYE, ALADEE R MD","ppno":"757\/380-8709","pcpadd":"4714 MARSHALL AVE","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23607,"pcpcounty":"","pcpid":142743,"pcpname":"","plan":"OHP","program":"ACA","lob":"Individual","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z46.82","J93.9","D86.9","J45.50","D86.0","J90.","J98.11","R09.02","G47.33","Z98.890","Z99.81","E11.65","E78.9","I10.","G25.81","D49.1","R91.8","Z12.11","J98.4","E11.69","D86.2","H40.023","L60.3","B35.1","E11.42","Z12.12","Z01.810","Z51.81","R94.31","Z79.01","I31.3","I51.7","J43.9","J20.9","J45.909","E11.9","Z48.813","H40.9","F32.9","K21.9","Z79.4","Z79.52","Z79.891","Z91.81","R69.","Z79.899","Z01.818","J18.1","J81.1","Z72.821","S61.211A"],"date":["2020-01-20","2020-01-20","2020-11-03","2021-11-23","2021-11-15","2021-11-12","2021-11-12","2021-07-13","2021-11-15","2021-11-15","2021-07-13","2021-02-08","2021-02-08","2021-08-09","2021-11-03","2020-01-17","2021-11-15","2021-01-26","2020-11-03","2021-08-09","2020-12-10","2020-12-10","2021-10-28","2021-10-28","2021-10-28","2021-01-26","2020-01-10","2020-01-10","2020-01-10","2020-01-10","2020-01-16","2020-02-19","2020-02-19","2020-02-20","2020-01-27","2020-01-27","2020-01-27","2020-01-27","2020-01-27","2020-01-27","2020-01-27","2020-01-27","2020-01-27","2020-01-27","2020-08-29","2020-11-06","2020-01-10","2020-01-19","2020-01-20","2021-11-15","2021-10-19"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"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":[]}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","67877056105","METFORMIN","500MG","60","Select","Select",""],["","00904645780","DOK","100MG","30","Select","Select",""],["","29300012810","HYDROCHLOROT","25MG","30","Select","Select",""],["","43547035610","LISINOPRIL","40MG","30","Select","Select",""],["","50111078710","AZITHROMYCIN","250MG","-6","Select","Select",""],["","00088222033","LANTUS","100\/ML","30","Select","Select",""],["","67877019905","AMLODIPINE","10MG","90","Select","Select",""],["","00406012301","HYDROCO\/APAP","5-325MG","40","Select","Select",""],["","59310057922","PROAIR","","8","Select","Select",""],["","00085461001","DULERA","200-5MCG","13","Select","Select",""],["","00186037020","SYMBICORT","160-4.5","10","Select","Select",""],["","00310737020","BUDES\/FORMOT","160-4.5","10","Select","Select",""],["","59746017206","PREDNISONE","5MG","15","Select","Select",""],["","11822001780","RA","100MG","60","Select","Select",""],["","64380071206","BENZONATATE","100MG","-30","Select","Select",""],["","58160088552","FLUARIX","2020-21","0","Select","Select",""],["","62542030104","HYD","10-8\/5ML","125","Select","Select",""],["","08290328418","INSULIN","1ML\/31G","100","Select","Select",""],["","53885024450","ONETOUCH","ULTRA","-100","Select","Select",""],["","72205002590","ATORVASTATIN","80MG","30","Select","Select",""],["","66993001968","ALBUTEROL","HFA","18","Select","Select",""],["","00487020103","IPRATROPIUM\/","ALBUTER","-90","Select","Select",""],["","43547035610","LISINOPRIL ","40MG","30","Select","Select",""],["","29300012810","HYDROCHLOROT ","25MG","30","Select","Select",""],["","00904645780","DOK ","100MG","30","Select","Select",""],["","67877056105","METFORMIN ","500MG","60","Select","Select",""],["","31722094101","HYDROCO\/APAP ","5-325MG","40","Select","Select",""],["","11822001780","RA ","100MG","60","Select","Select",""],["","64380071206","BENZONATATE ","100MG","-30","Select","Select",""],["","62542030104","HYD ","10-8\/5ML","118","Select","Select",""],["","00088222033","LANTUS ","100\/ML","-30","Select","Select",""],["","65862064163","AZITHROMYCIN ","250MG","6","Select","Select",""],["","59746017306","PREDNISONE ","10MG","26","Select","Select",""],["","72205002590","ATORVASTATIN ","80MG","90","Select","Select",""],["","67877019905","AMLODIPINE ","10MG","30","Select","Select",""],["","08290328418","INSULIN ","1ML\/31G","100","Select","Select",""],["","00085461001","DULERA ","200-5MCG","13","Select","Select",""],["","59310057922","PROAIR ","","8","Select","Select",""],["","66993001968","ALBUTEROL ","HFA","18","Select","Select",""],["","00186037020","SYMBICORT ","160-4.5","10","Select","Select",""],["","00310737020","BUDES\/FORMOT ","160-4.5","10","Select","Select",""],["","00487020103","IPRATROPIUM\/ ","ALBUTER","90","Select","Select",""],["","58160088552","FLUARIX ","2020-21","0","Select","Select",""],["","53885024450","ONETOUCH ","ULTRA","-100","Select","Select",""],["","63304061650","DOXYCYC","100MG","20","Select","Select",""],["","63304061650","DOXYCYC ","CAP 100MG","20","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}