{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CRYSTAL   L HILLER","gend":1,"add":"715 WOODS RD APT B315","city":"NEWPORT NEWS","state":"VA","zip":"23601-9998","dob":"1987-10-21","age":"","mstatus":"","insh":"1257360*01","cliId":"","pno":"757\/243-2843","cno":"","email":"","ename":"","eno":"","pphy":"JONES, JOEL M DO","ppno":"757\/316-5050","pcpadd":"209 VILLAGE AVE STE P","pcpcity":"YORKTOWN","pcpstate":"VA","pcpzip":23693,"pcpcounty":"","pcpid":"","pcpname":"Riverside Tappahannock Hospital - ED","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/369-2999","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","M54.16","M51.26","M51.27","M54.5","G89.29","Z98.890","Z23.","F41.8","R10.11","R73.09","F17.210","M54.9","G93.2","J45.30","Z85.41","R10.9","M54.31","R60.0","M51.17","M51.16","M79.89","H60.90","K08.89","R22.42","Z00.00","NO DATA","J45.40","F12.90"],"date":["2021-12-20","2021-10-13","2021-02-23","2021-03-02","2021-05-27","2021-05-27","2021-05-27","2020-09-15","2021-10-13","2020-09-15","2020-09-15","2021-10-13","2021-02-23","2021-02-23","2021-02-23","2021-10-13","2021-02-23","2020-05-31","2020-11-16","2021-12-20","2021-03-02","2021-01-18","2020-01-25","2020-01-25","2020-12-15","2021-10-13","2021-10-13","2021-10-13","2021-10-13"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","","ESCITALOPRAM","TAB 10MG","","Select","Select",""],["","","GABAPENTIN","CAP 100MG","","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","","LIDOCAINE","SOL 2% VISC","","Select","Select",""],["","","FLOVENT","AER 110MCG","","Select","Select",""],["","","ONETOUCH","MIS LANCETS","","Select","Select",""],["","","CLINDAMYCIN","CAP 300MG","","Select","Select",""],["","","OFLOXACIN","DRO 0.3%OTIC","","Select","Select",""],["","","METHOCARBAM","TAB 500MG","","Select","Select",""],["","","MELOXICAM","TAB 15MG","","Select","Select",""],["","","PROAIR","AER ","","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":""}]}]}