{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TEANNAA TALIAFERRO","gend":1,"add":"2052 CUNNINGHAM DRIVE APT 204 KEVIN HARRINGTON","city":"HAMPTON","state":"VA","zip":"23666-9998","dob":"2000-08-17","age":"","mstatus":"","insh":"1220789*01","cliId":"","pno":"757\/637-5433","cno":"","email":"","ename":"","eno":"","pphy":"HERBERT, DWIGHT C MD","ppno":"757\/594-4431","pcpadd":"12420 WARWICK BLVD BLDG 4 SUITE 4A","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23606,"pcpcounty":"","pcpid":"","pcpname":"Riverside Primary Care - Hidenwood","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/594-2936","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L02.31","R00.0","R53.83","Z01.419","Z11.3","Z13.29","F43.10","F31.64","L30.9","R59.0","R30.0","R10.84","R11.0","R63.0","N89.8","R10.2","R76.8","R50.9","NO DATA","Z20.822","B19.20","R52.","N72.","N76.0","B96.89","R07.89","R68.83","R31.9","R11.2","R10.13","R07.9","F39.","R51.9","H53.9","J35.1","Z81.8","R44.0","F41.9","F33.3","Z88.0","Z88.8","J35.8","Z76.89","Z20.828","K11.7","H04.203","K08.89","Z91.89","B35.4","N91.1","Z32.02","F31.60","B37.3","N20.0","R10.31","Z79.899","M54.2","N93.9","G44.019","R09.89","H92.02","S16.1XXA","S60.221A","S00.12XA","M25.511","M25.531","M25.521","N92.1","R31.1"],"date":["2021-01-25","2021-01-25","2021-01-25","2021-12-06","2021-12-06","2021-12-06","2022-06-17","2022-04-15","2022-08-31","2022-01-19","2022-01-19","2022-01-19","2022-01-31","2022-01-19","2022-01-19","2022-01-21","2020-08-06","2021-08-22","2022-02-02","2021-08-22","2022-01-31","2021-01-06","2021-06-06","2022-04-25","2022-04-25","2021-08-22","2021-08-22","2022-06-29","2022-06-29","2022-06-29","2021-08-22","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-12-10","2022-02-02","2022-02-11","2022-06-29","2022-06-29","2020-10-09","2020-10-09","2021-01-07","2021-03-09","2021-03-09","2021-03-09","2021-03-09","2021-03-09","2021-06-10","2021-06-10","2022-06-17","2021-01-20","2021-02-28","2021-02-28","2022-01-21","2020-07-13","2020-12-14","2021-06-22","2020-06-10","2020-09-07","2022-10-01","2022-10-01","2022-10-01","2022-10-01","2022-10-01","2022-10-01","2022-10-31","2022-10-31"],"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":[]},{"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":[["","68462015713","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","49035045875","ALLERGY","TAB 10MG","90","Select","Select",""],["","63044015001","PRENATAL","TAB LOW IRON","30","Select","Select",""],["","58657017001","M-NATAL","TAB ","30","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","15","Select","Select",""],["","68645052154","SERTRALINE","TAB 25MG","30","Select","Select",""],["","16714079904","CETIRIZINE","TAB 10MG","90","Select","Select",""],["","68180044501","QUETIAPINE","TAB 25MG","30","Select","Select",""],["","29300011101","LAMOTRIGINE","TAB 25MG","30","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","30","Select","Select",""],["","65197010305","MICATIN","CRE 0.02","28","Select","Select",""],["","51672129802","KETOCONAZOLE","CRE 0.02","30","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","15","Select","Select",""],["","29300041319","CYCLOBENZAPR","TAB 5MG","9","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","00555077902","MEDROXYPR","TAB 10MG","30","Select","Select",""],["","72647033104","METHYLPRED","TAB 4MG","21","Select","Select",""],["","16714079701","SUMATRIPTAN","TAB 50MG","30","Select","Select",""],["","10702025301","BUT\/APAP\/CAF","TAB ","30","Select","Select",""],["","45802008801","ALBUTEROL","AER HFA","8","Select","Select",""],["","42192060716","BROM\/PSE\/DM","SYP ","840","Select","Select",""],["","70710111208","TIZANIDINE","CAP 4MG","30","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","20","Select","Select",""],["","50383077504","LIDOCAINE","SOL 2% VISC","100","Select","Select",""],["","00904582360","VITAMIN","TAB 400UNIT","180","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":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"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":""}]}]}