{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DISHEKA   L ADAMS","gend":1,"add":"509 SOUTHAMPTON ST","city":"EMPORIA","state":"VA","zip":"23847-9998","dob":"1986-05-06","age":"","mstatus":"","insh":"20022866*01","cliId":"","pno":"252\/370-5111","cno":"252\/370-5111","email":"","ename":"","eno":"","pphy":"SINGER, LAWRENCE DAVID MD","ppno":"252\/535-4343","pcpadd":"63 OFFICE PARK DRIVE","pcpcity":"ROANOKE RAPIDS","pcpstate":"NC","pcpzip":27870,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"252\/308-0977","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.1","F33.9","F25.1","F25.0","Z01.419","N92.6","N84.1","Z77.120","F17.210","N93.9","N89.8","N93.0","N76.1","Z11.3"],"date":["2020-06-04","2020-06-04","2020-06-04","2020-07-01","2021-10-14","2021-06-10","2021-06-14","2020-05-10","2020-05-10","2021-08-05","2021-12-29","2021-12-29","2021-08-05","2021-06-10"],"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":[]},{"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":[["","00245086070","VANDAZOLE","GEL 0.0075","70","Select","Select",""],["","33342008307","OLANZAPINE","TAB 5MG ODT","90","Select","Select",""],["","73473030370","METRONIDAZOL","GEL 0.75%VAG","70","Select","Select",""],["","10702001150","HYDROXYZ","TAB 25MG","60","Select","Select",""],["","69097083305","SERTRALINE","TAB 25MG","30","Select","Select",""],["","68180016111","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","14","Select","Select",""],["","75826011510","PHENAZOPYRID","TAB 200MG","9","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","00555077902","MEDROXYPR","TAB 10MG","14","Select","Select",""],["","00378334053","XULANE","DIS 150-35","3","Select","Select",""],["","16571041250","CIPROFLOXACN","TAB 500MG","10","Select","Select",""],["","65862077685","MILI","TAB 0.25\/35","28","Select","Select",""],["","68382003516","VENLAFAXINE","CAP 75MG ER","30","Select","Select",""],["","75854060203","BALCOLTRA","TAB 0.1-20","28","Select","Select",""],["","16714036004","MONO-LINYAH","TAB 0.25-35","28","Select","Select",""],["","42494030112","HYDROCORT","SUP 25MG","24","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":""}]}]}