{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TANIQUA   C HALL","gend":1,"add":"5474 POPLAR DR DR APT 202","city":"NORFOLK","state":"VA","zip":"23502-9998","dob":"1995-02-23","age":"","mstatus":"","insh":"1750902*01","cliId":"","pno":"757\/839-0089","cno":"","email":"","ename":"","eno":"","pphy":"HOWELL, CHRISTINE NP","ppno":"757\/955-2828","pcpadd":"885 KEMPSVILLE RD STE 320","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23502,"pcpcounty":"","pcpid":"","pcpname":"AMELIA MEDICAL ASSOCIATES","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/955-2829","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G56.22","Z48.02","H11.422","B30.3","NO DATA","H10.45","K21.9","H05.20","E88.81","E66.01","Z20.822","R03.0","R51.9","Z11.3","Z11.4","K59.00","H60.92","H92.09","H69.90","H93.293","Z01.10","Z01.818","R00.2","R79.89","R94.31","R06.02","N76.0","F33.1","H66.002","H66.001","H61.20","B37.3","Z20.828","R35.0","E66.9","F41.9","Z79.899","Z68.38","R11.0","J30.9","B30.8","H66.92","J06.9","E55.9","D57.00","H57.12","Z68.34","R10.84","N39.0","S90.122A","H65.192","Z23.","R73.01","R82.81","Z32.02","H00.011","R10.13","N30.01"],"date":["2021-03-19","2021-03-19","2021-04-12","2021-04-23","2022-04-18","2021-04-23","2022-02-17","2021-11-17","2020-11-25","2020-12-11","2022-11-20","2022-02-04","2022-04-23","2022-10-23","2022-10-23","2022-10-23","2020-10-08","2020-11-11","2020-11-11","2021-01-11","2021-01-11","2021-02-22","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2022-09-15","2022-04-07","2020-08-11","2020-08-11","2020-09-24","2022-03-20","2022-02-03","2022-02-03","2022-04-18","2022-04-18","2022-04-18","2022-04-18","2022-04-18","2020-11-11","2021-04-15","2022-05-28","2022-11-20","2022-04-07","2020-12-11","2021-04-14","2020-01-09","2020-03-20","2020-03-20","2020-04-20","2020-08-22","2020-12-11","2020-12-11","2021-04-08","2021-04-08","2021-07-20","2022-02-04","2022-03-20"],"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":[["","43547028111","ESCITALOPRAM","TAB 10MG","90","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","53191036201","D3-50","CAP 50000UNT","12","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00093226301","AMOXICILLIN","TAB 500MG","20","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","6","Select","Select",""],["","00023916360","RESTASIS","EMU 0.05% OP","180","Select","Select",""],["","60505620202","CYCLOSPORINE","EMU 0.05% OP","180","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","100","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00006468100","M-M-R","INJ ","1","Select","Select",""],["","00006482700","VARIVAX","INJ ","1","Select","Select",""],["","65862064163","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","69315030805","CIPROFLOXACN","SOL 0.3% OP","5","Select","Select",""],["","00406052201","OXYCOD\/APAP","TAB 7.5-325","20","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","10","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","30","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","61314063006","NEO\/POLY\/DEX","SUS 0.1% OP","5","Select","Select",""],["","55111064530","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","61314062810","POLYMYXIN","SOL TRIMETHP","10","Select","Select",""],["","69238126601","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","14","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","50","Select","Select",""],["","00065853302","CIPRODEX","SUS 0.3-0.1%","8","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","15","Select","Select",""],["","51991081403","AZELASTINE","SPR 0.001","30","Select","Select",""],["","00781618667","CIPRO\/DEXA","SUS 0.3-0.1%","8","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":""}]}]}