{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MICHAEL  A JOHNSON","gend":0,"add":"15 CHRISTINE CT","city":"HAMPTON","state":"VA","zip":23666,"dob":"1958-05-27","age":"","mstatus":"","insh":"20030070*01","cliId":"","pno":"757\/838-5629","cno":"","email":"","ename":"","eno":"","pphy":"Emechebe, Nonso","ppno":"757\/827-2025","pcpadd":"4001 Coliseum Drive Suite 300","pcpcity":"Hampton","pcpstate":"VA","pcpzip":23666,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family & Internal Medicine Physicians - CarePlex West","plan":"OHP","program":"Medicaid","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/275-9802","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E78.2","I10.","K21.9","E11.65","F32.89","NO DATA","E55.9","Z12.5","R51.9","S29.9XXA","I45.10","Z88.6","Z91.013","Z87.891","F43.10","K76.0","E11.9","R07.9","R55.","R07.89","S93.601A","M25.552","M25.512","M54.9","W10.8XXA","Z23.","M17.10","Z12.11","E78.49","F32.9","S09.90XA","M25.561","N52.9","V58.89","M17.11","M79.661","Z71.3","S63.592A","M19.032","M19.042","M18.12","W01.0XXA","R22.2","S69.92XA","L72.0","M25.511"],"date":["2021-09-29","2021-12-26","2020-05-26","2021-09-29","2021-09-29","2021-12-26","2021-09-29","2020-05-26","2021-07-30","2021-12-26","2021-12-26","2021-12-26","2021-12-26","2021-12-26","2021-12-26","2021-12-26","2021-12-26","2021-12-26","2021-01-07","2021-12-26","2020-09-07","2021-05-31","2021-05-31","2021-05-31","2021-05-31","2021-09-29","2021-09-29","2021-09-29","2020-05-26","2020-05-26","2021-05-31","2021-08-02","2019-10-22","2019-02-27","2019-02-19","2019-02-19","2019-02-19","2019-02-26","2019-02-26","2019-02-26","2019-02-26","2019-02-26","2019-04-29","2019-02-16","2019-06-18","2019-06-18"],"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":[["","68180063702","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","62175061746","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","67877049090","EZETIMIBE","TAB 10MG","30","Select","Select",""],["","00172208380","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","65862000801","METFORMIN","TAB 500MG","30","Select","Select",""],["","00597014030","TRADJENTA","TAB 5MG","30","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","60","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","65862019401","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","50742062201","NIFEDIPINE","TAB 90MG ER","30","Select","Select",""],["","70436015301","POT  CHLORIDE","TAB 20MEQ ER","30","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","20","Select","Select",""],["","56151146004","TRUE","TES GLUCOSE","50","Select","Select",""],["","00536117201","ACETAMIN","TAB 500MG","20","Select","Select",""],["","53885024450","ONETOUCH","TES ULTRA","50","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}