{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PAMELA   M SEAY","gend":1,"add":"433 BRUNSWICK VLG DR APT 433","city":"LAWRENCEVILLE","state":"VA","zip":"23868-9998","dob":"1988-07-06","age":"","mstatus":"","insh":"20034712*01","cliId":"","pno":"804\/892-6390","cno":"","email":"","ename":"","eno":"","pphy":"ESQUIVEL, MARISSA W MD","ppno":"434\/292-7261","pcpadd":"213 NORTH MAIN ST","pcpcity":"BLACKSTONE","pcpstate":"VA","pcpzip":23824,"pcpcounty":"","pcpid":"","pcpname":"BLACKSTONE FAMILY PRACTICE CENTER","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/292-7965","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H61.23","R00.0","I49.9","R42.","R00.2","D72.820","D47.3","E55.9","R53.83","R73.03","Z31.69","Z68.33","Z30.430","Z20.828","N60.19","N64.4","R92.8","Z30.431","M53.3","W19.XXXA","M85.80","Z68.32","G56.01","G56.02","F41.9","R74.0","H66.91","Z20.822","Z01.419","Z30.42","Z11.3","G56.03","M79.672","R53.1","Z86.32","D72.9","N80.9","N95.8","Z12.72","Z97.5","N92.0","D72.829","M89.8X9","R79.89","F33.1","F41.1","Z68.34","R10.13","R19.7","K90.41","K52.9","K58.1","Z32.02","R21.","Z68.35","R87.620"],"date":["2020-01-11","2020-10-29","2020-06-10","2020-06-10","2021-07-01","2020-07-13","2021-09-02","2021-08-05","2021-08-05","2021-08-05","2021-08-05","2021-08-05","2020-11-13","2021-01-14","2021-06-16","2021-06-16","2021-06-16","2021-08-04","2021-10-28","2021-10-28","2021-10-28","2021-10-28","2021-09-02","2021-09-02","2020-07-13","2020-07-13","2021-03-26","2021-08-19","2021-10-27","2020-09-25","2020-09-25","2021-09-02","2021-09-02","2020-04-20","2020-04-20","2020-04-20","2020-07-15","2021-05-21","2021-10-27","2021-10-27","2020-01-16","2021-03-11","2021-03-11","2021-03-11","2019-09-09","2019-09-09","2019-12-30","2019-08-07","2019-08-07","2019-12-30","2019-10-18","2019-01-07","2019-05-20","2019-12-30","2019-04-04","2019-08-27"],"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":[["","57237002801","AMOXICILLIN","TAB 500MG","30","Select","Select",""],["","","METOPROL","TAB 25MG ER","","Select","Select",""],["","80681007200","VITAMIN","TAB 500MCG","90","Select","Select",""],["","59746021106","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","45","Select","Select",""],["","59762453701","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","42806016001","HYDROXYZ","TAB 25MG","30","Select","Select",""],["","45802086803","POLYETH","POW 3350 NF","510","Select","Select",""],["","10572030201","PEG-3350\/KCL","SOL \/SODIUM","4000","Select","Select",""],["","04142000040","FLORASTOR","PAK 250MG","30","Select","Select",""],["","13668000901","CITALOPRAM","TAB 10MG","30","Select","Select",""],["","11822334910","RA","DRO 6.5% OT","15","Select","Select",""],["","00904662735","EAR","DRO 0.065","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":""}]}]}