{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROSA   L LINDSEY","gend":1,"add":"9534 20TH BAY ST APT 7","city":"NORFOLK","state":"VA","zip":"23518-9998","dob":"1949-12-25","age":"","mstatus":"","insh":"20031150*01","cliId":"","pno":"757\/963-7054","cno":"","email":"","ename":"","eno":"","pphy":"FEE, ERIC MD","ppno":"757\/587-0157","pcpadd":"7924 CHESAPEAKE BLVD","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23518,"pcpcounty":"","pcpid":"","pcpname":"Bayview Medical Center","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/587-0074","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","G62.9","H26.9","K21.9","M10.9","E11.649","I10.","I51.7","I51.89","E13.10","E87.2","N26.9","N18.4","A41.9","J96.01","I50.33","J18.9","I13.0","Z68.42","Z20.822","E11.22","E66.01","Z88.5","I25.10","NO DATA","Z79.4","Z79.899","Z82.49","Z83.3","D63.1","J81.0","I87.2","I89.0","R53.1","R06.89","E11.10","N17.9","G93.41","N18.9","R25.3","E83.41","E16.2","E87.6","N28.9","W19.XXXA","N28.1","E83.9","M89.9","E83.51","I12.9","E11.21","I12.0","N18.6","R19.7","R10.9","R11.10","Z99.2","R26.89","R11.2","E11.43","E88.09","Z68.43","R10.30","D64.9","R10.819","R10.84","D72.829","Z01.818","Z79.82"],"date":["2021-12-28","2021-12-28","2021-12-28","2022-10-18","2021-12-28","2022-11-13","2022-11-15","2021-07-11","2021-07-14","2021-07-15","2021-07-15","2022-10-26","2022-10-26","2021-08-19","2021-08-21","2021-08-19","2021-08-19","2021-08-19","2021-08-19","2021-08-19","2022-11-06","2022-11-06","2022-10-18","2022-11-06","2022-10-26","2022-11-06","2022-10-18","2022-11-06","2021-08-19","2022-11-06","2021-08-21","2021-12-28","2021-12-28","2022-11-06","2022-11-01","2021-07-15","2022-10-26","2021-07-15","2021-07-15","2021-07-10","2021-07-10","2022-11-16","2022-11-06","2019-05-03","2019-05-03","2019-05-28","2019-03-28","2019-03-28","2022-11-08","2022-10-26","2022-10-26","2022-11-14","2022-11-16","2022-11-06","2022-11-08","2022-11-08","2022-11-16","2022-11-14","2022-11-13","2022-11-14","2022-11-06","2022-11-06","2022-11-06","2022-11-15","2022-11-07","2022-11-02","2022-11-16","2022-10-25","2022-10-18"],"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":[["","59779027408","ASPIRIN","CHW 81MG","30","Select","Select",""],["","23155000401","HYDRALAZINE","TAB 100MG","90","Select","Select",""],["","57664050658","METOPROL","TAB 25MG","180","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","33342007610","VALSART\/HCTZ","TAB 160-25MG","90","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","60","Select","Select",""],["","08290328203","BD  PEN NEEDL","MIS 29GX12.7","300","Select","Select",""],["","65862050220","AMOX\/K","TAB 500-125","10","Select","Select",""],["","08290324909","INSULIN","MIS 0.3\/31G","100","Select","Select",""],["","50090554700","JANUVIA","TAB 25MG","30","Select","Select",""],["","53746074501","PROMETHAZINE","TAB 12.5MG","20","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","10","Select","Select",""],["","55513014401","EPOGEN","INJ 10000\/ML","12","Select","Select",""],["","80681013800","CALCIUM\/D3","TAB 600MG","60","Select","Select",""],["","49884012201","LABETALOL","TAB 100MG","60","Select","Select",""],["","64980029410","SODIUM","TAB 10GR","60","Select","Select",""],["","56151146004","TRUE","TES GLUCOSE","50","Select","Select",""],["","70377002811","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","00002751001","HUMALOG","INJ 100\/ML","10","Select","Select",""],["","53885059501","ONETOUCH","MIS 30G","300","Select","Select",""],["","69842080601","CVS","TAB 600MG","20","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","65702071110","ACCU-CHEK","TES GUIDE","50","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","TES LITE","300","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","08508200005","OMNIPOD","MIS 5 PACK","10","Select","Select",""],["","00093081001","NORTRIPTYLIN","CAP 10MG","90","Select","Select",""],["","68180052001","LISINOP\/HCTZ","TAB 20-25MG","30","Select","Select",""],["","70710121005","ALLOPURINOL","TAB 300MG","30","Select","Select",""],["","76385011350","CARVEDILOL","TAB 25MG","60","Select","Select",""],["","00185012901","BUMETANIDE","TAB 1MG","30","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":""}]}]}