{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JANET   L SCOTT","gend":1,"add":"1000 LITTON LANE APT 1G","city":"SUFFOLK","state":"VA","zip":"23434-9998","dob":"1963-12-21","age":"","mstatus":"","insh":"20034644*01","cliId":"","pno":"757\/647-6280","cno":"","email":"","ename":"","eno":"","pphy":"MUGAISI, HESED N MD","ppno":"757\/738-1375","pcpadd":"148 BURNETTS WAY STE 107","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23434,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS SUFFOLK PRIMARY CARE","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/934-6935","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["B02.9","R11.0","F17.210","I10.","R53.81","N17.9","B02.23","R55.","R07.89","R11.2","Z20.828","R07.9","Z53.29","R42.","B02.8","I21.4","M54.12","R73.03","F32.9","E78.5","E55.9","Z79.899","Z79.1","Z88.5","Z88.6","Z88.8","Z82.49","N81.4","R10.2","K21.9","R10.84","F33.42","R23.2","D50.9","Z12.31","E07.9","M62.838","N95.1","E66.01","Z12.11","M89.372","N81.9","Z01.810","N81.10","F17.200","E11.9","Z68.30","E87.1","B02.29","F12.10","R63.4","M60.9","R73.9","T38.0X5A","K44.9","G89.29","E86.0","R25.3","M62.82","N30.01","N99.3","S46.811A","S46.812A","M54.2","R77.8","M54.14","N81.2","L29.9","R06.00","Z72.0","R74.8","R51.9","R30.0","K59.00","N39.0","F39.","F11.90","H40.013","Q07.00"],"date":["2020-10-21","2020-10-05","2020-10-28","2021-11-01","2020-10-09","2020-11-11","2020-10-20","2020-10-20","2020-10-28","2020-10-30","2020-10-26","2020-10-30","2020-10-04","2020-10-04","2020-10-21","2020-10-08","2020-10-07","2020-10-28","2020-10-28","2021-11-01","2020-10-28","2020-10-07","2020-10-07","2020-10-07","2020-10-07","2020-10-07","2020-10-07","2021-07-16","2021-01-04","2020-10-21","2020-10-27","2021-07-12","2021-02-17","2021-02-17","2021-02-17","2021-02-17","2021-02-17","2021-07-12","2021-07-12","2021-07-12","2021-12-21","2021-01-04","2021-10-27","2021-11-01","2021-11-01","2021-11-01","2020-10-27","2020-10-28","2020-10-30","2020-10-31","2020-10-28","2020-11-11","2020-11-11","2020-10-28","2020-10-28","2020-10-28","2020-10-28","2020-10-30","2020-10-30","2020-10-31","2021-09-24","2020-07-13","2020-07-13","2020-07-13","2020-10-08","2020-10-23","2021-11-01","2020-10-01","2020-10-07","2020-10-07","2020-10-07","2020-10-21","2020-11-01","2020-11-01","2020-11-11","2020-11-11","2020-11-11","2019-07-26","2019-06-06"],"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":[["","65862019201","FLUOXETINE","CAP 10MG","30","Select","Select",""],["","","VITAMIN","CAP 50000UNT","","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","","IBUPROFEN","TAB 600MG","","Select","Select",""],["","53885013610","ONETOUCH","MIS LANCETS","100","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","","METFORMIN","TAB 500MG ER","","Select","Select",""],["","","NITROFURANTN","CAP 100MG","","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","55111012205","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","00555088602","ESTRADIOL","TAB 1MG","30","Select","Select",""],["","31722072250","LEVOFLOXACIN","TAB 500MG","7","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","","TRAMADOL","TAB 50MG","","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","","CVS","TAB 8.6MG","","Select","Select",""],["","","PREGABALIN","CAP 100MG","","Select","Select",""],["","","HYDROXYZ","TAB 50MG","","Select","Select",""],["","","PROMETHAZINE","TAB 25MG","","Select","Select",""],["","","PREDNISONE","TAB 10MG","","Select","Select",""],["","","FUROSEMIDE","TAB 20MG","","Select","Select",""],["","","METHOCARBAM","TAB 750MG","","Select","Select",""],["","","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","","CELECOXIB","CAP 200MG","","Select","Select",""],["","","SENOKOT","TAB 8.6MG","","Select","Select",""],["","","CARBAMAZEPIN","TAB 200MG","","Select","Select",""],["","","DOK","CAP 100MG","","Select","Select",""],["","","VALACYCLOVIR","TAB 500MG","","Select","Select",""],["","","BISACODYL","TAB 5MG EC","","Select","Select",""],["","","ARTHRICREAM","CRE 0.1","","Select","Select",""],["","","DEXAMETHASON","TAB 1MG","","Select","Select",""],["","","BENADRYL","CAP 25MG","","Select","Select",""],["","","DICLOFENAC","TAB 50MG DR","","Select","Select",""],["","","SENNOSIDES","TAB 8.6MG","","Select","Select",""],["","","ASPERCREME","CRE \/ALOE","","Select","Select",""],["","","SENNA","TAB 8.6MG","","Select","Select",""],["","","GABAPENTIN","CAP 100MG","","Select","Select",""],["","","PANTOPRAZOLE","TAB 20MG","","Select","Select",""],["","","POLYETH","POW 3350 NF","","Select","Select",""],["","","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","","LIDOCAINE","PAD 0.05","","Select","Select",""],["","","HYDROCORT","CRE 0.025","","Select","Select",""],["","","GENTLE","TAB 5MG EC","","Select","Select",""],["","","VIRT-CAPS","CAP ","","Select","Select",""],["","00713022515","TRIAMCINOLON","CRE 0.001","15","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":""}]}]}