{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"COURTNEY   M WRENN","gend":1,"add":"630 MAIN ST APT B","city":"SMITHFIELD","state":"VA","zip":"23430-9998","dob":"1983-02-25","age":"","mstatus":"","insh":"1372722*01","cliId":"","pno":"757\/371-4779","cno":"757\/775-1094","email":"","ename":"","eno":"","pphy":"STEVENSON, MICHAEL G PA","ppno":"757\/357-3331","pcpadd":"201 GUMWOOD DRIVE","pcpcity":"SMITHFIELD","pcpstate":"VA","pcpzip":23430,"pcpcounty":"","pcpid":"","pcpname":"FAMILY MEDICAL CARE OF SMITHFIELD PLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/356-9711","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","B07.0","L60.3","M21.6X1","M21.6X2","M20.11","M20.12","M20.5X1","E11.65","E11.43","Z01.818","M77.12","I10.","Z79.4","E03.9","E55.9","E66.9","Z98.84","Z00.00","Z68.33","E78.5","F32.1","Z13.89","D50.8","H04.123","E11.3292","H15.101","L93.0","J06.9","J02.9","M54.9","N30.00","E11.21","R81.","N92.4","N92.6","Z68.41","Z68.34","M51.36","G89.29","R10.2","S20.229A","S50.00XA","D48.61","Z96.41","Z88.6","R11.0","N63.14","M62.81","M25.522","M25.521","M46.1","Z46.81","Z68.36","Z23.","T78.40XA","Z01.812","Z20.822","M53.88","M47.896","M65.9","S50.12XA","S76.012A","Z32.02","N60.21","R10.31","Z45.89","G47.33","NO DATA","S50.11XA","R23.4","V58.89","M79.671","M54.5","M25.541","M25.542","R10.13","K28.9","D50.9","M79.674","S83.91XA","E66.01","K91.2","Z77.22","R13.19","E11.8","Z68.35","E11.3293","H25.13","R11.2","K28.7","Z13.31","N39.0","S93.521A","S96.019A","M72.2","M24.571"],"date":["2021-10-21","2020-11-24","2021-09-14","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-12-20","2021-12-30","2021-07-08","2021-04-27","2021-12-30","2021-12-30","2021-12-30","2021-12-30","2021-12-30","2021-10-21","2020-01-13","2021-04-26","2020-01-13","2020-07-13","2020-01-13","2021-11-11","2020-08-24","2020-08-24","2020-08-24","2020-08-24","2020-09-25","2020-09-25","2020-10-08","2021-10-21","2020-12-31","2020-12-31","2021-07-16","2021-07-08","2021-07-08","2021-07-28","2021-10-05","2021-12-02","2021-10-21","2020-10-09","2020-10-09","2021-08-31","2021-10-21","2021-10-21","2021-10-21","2021-07-28","2021-09-01","2021-09-01","2021-09-01","2021-12-02","2020-08-20","2020-12-07","2021-10-11","2021-02-16","2021-05-05","2021-04-21","2021-12-02","2021-12-02","2020-12-30","2020-12-02","2020-12-30","2021-05-05","2021-08-31","2021-10-21","2021-02-16","2021-07-16","2021-08-31","2020-10-21","2021-04-26","2019-05-07","2019-09-10","2019-09-23","2019-09-23","2019-09-23","2019-10-28","2019-11-20","2019-10-28","2019-02-02","2019-02-02","2019-07-03","2019-10-18","2019-07-03","2019-10-18","2019-07-03","2019-07-03","2019-08-12","2019-08-12","2019-10-18","2019-11-20","2019-01-04","2019-01-04","2019-02-12","2019-02-12","2019-09-10","2019-09-10"],"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":[["","00527293441","PREDNISONE","TAB 20MG","10","Select","Select",""],["","54629794101","VITAMIN","TAB 5000UNIT","30","Select","Select",""],["","","OXYCODONE","TAB 5MG","","Select","Select",""],["","00002773701","INSULIN","INJ 100\/ML","60","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","68462010340","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","57237021990","PIOGLITAZONE","TAB 15MG","90","Select","Select",""],["","00597015230","JARDIANCE","TAB 10MG","30","Select","Select",""],["","","METHOCARBAM","TAB 750MG","","Select","Select",""],["","49884072703","DOXYCYC","CAP 100MG","14","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","60","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","00169406013","VICTOZA","INJ 18MG\/3ML","9","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","","NITROFUR","CAP 100MG","","Select","Select",""],["","","DICLOFENAC","TAB 75MG DR","","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","60","Select","Select",""],["","00143992950","CIPROFLOXACN","TAB 750MG","14","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","","TRAZODONE","TAB 50MG","","Select","Select",""],["","16729022601","SPIRONOLACT","TAB 50MG","90","Select","Select",""],["","","CEFDINIR","CAP 300MG","","Select","Select",""],["","08290320119","BD  PEN NEEDL","MIS 31GX5MM","100","Select","Select",""],["","","CEFTRIAXONE","INJ 250MG","","Select","Select",""],["","00002751001","HUMALOG","INJ 100\/ML","20","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","65862000899","METFORMIN","TAB 500MG","60","Select","Select",""],["","","AZITHROMYCIN","TAB 500MG","","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","58914017014","CARAFATE","SUS 1GM\/10ML","1200","Select","Select",""],["","13668013701","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","55111064505","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","51672128901","NYSTATIN","CRE 100000","15","Select","Select",""],["","64380080307","RANITIDINE","TAB 150MG","30","Select","Select",""],["","00065924007","DUREZOL","EMU 0.0005","5","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":""}]}]}