{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JESSICA  M HODGES","gend":1,"add":"13202 MATTIE CIR APT 9","city":"NEWPORT NEWS","state":"VA","zip":23608,"dob":"1986-12-19","age":"","mstatus":"","insh":"1250354*01","cliId":"","pno":"757\/369-0031","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"757\/968-5700","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23608,"pcpcounty":"","pcpid":"","pcpname":"Patriot Primary Care","plan":"OHP","program":"Medicaid","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"000\/000-0000","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J06.9","M54.9","R10.9","J02.9","L73.2","L70.0","Z71.9","N76.2","K12.0","E11.9","Z23.","R42.","R73.9","R68.89","R45.87","E55.9","F44.9","Z11.3","E66.01","Z68.41","Z87.59","N94.6","Z79.84","N94.3","F43.10","Z02.2","V62.84","E11.65"],"date":["2020-07-09","2020-07-09","2020-11-03","2019-09-08","2022-10-10","2021-02-09","2021-02-09","2020-03-31","2020-03-31","2022-10-10","2020-10-06","2019-08-17","2019-08-17","2022-03-29","2022-05-12","2022-03-29","2022-04-28","2022-03-29","2022-03-29","2022-03-29","2022-03-29","2022-04-21","2022-04-28","2022-10-02","2022-05-12","2022-10-10","2022-10-09","2022-10-09"],"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":[["","70010008401","PRAZOSIN","CAP 1MG","30","Select","Select",""],["","00169406012","VICTOZA","INJ 18MG\/3ML","9","Select","Select",""],["","00363011208","WAL-PHED","TAB 30MG","40","Select","Select",""],["","49884072703","DOXYCYC","CAP 100MG","180","Select","Select",""],["","08290320109","BD  PEN NEEDL","MIS 31GX8MM","100","Select","Select",""],["","63824005632","MUCINEX","TAB 30-600ER","60","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","70010049105","METFORMIN","TAB 500MG ER","360","Select","Select",""],["","67877043303","ARIPIPRAZOLE","TAB 15MG","30","Select","Select",""],["","00234057516","HIBICLENS","LIQ 0.04","473","Select","Select",""],["","00093077198","PRAVASTATIN","TAB 10MG","90","Select","Select",""],["","27241016430","DULOXETINE","CAP 40MG","30","Select","Select",""],["","45802056202","CLINDAMYCIN","SOL 0.01","60","Select","Select",""],["","","LIDOCAINE","SOL 2% VISC","","Select","Select",""],["","","AMOXICILLIN","SUS 400\/5ML","","Select","Select",""],["","","NYSTAT\/TRIAM","OIN ","","Select","Select",""],["","","DICLOFENAC","TAB 50MG DR","","Select","Select",""],["","","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","","DICYCLOMINE","CAP 10MG","","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":{"indx":[["","",""],[""],[""],[""],[""]],"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":""}]}]}