{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NATASHA SIMPSON","gend":1,"add":"1908 WARREN AVE # J 206 S 17TH AVENUE","city":"HOPEWELL","state":"VA","zip":"23860-9998","dob":"1973-03-25","age":"","mstatus":"","insh":"20034997*01","cliId":"","pno":"804\/352-5800","cno":"","email":"","ename":"","eno":"","pphy":"TUNSTALL, JUNE R MD","ppno":"804\/458-6396","pcpadd":"406 NORTH 6TH STREET","pcpcity":"HOPEWELL","pcpstate":"VA","pcpzip":23860,"pcpcounty":"","pcpid":"","pcpname":"June R. Tunstall, MD, PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/458-4934","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["B20.","E55.9","F17.210","Z79.899","M35.1","R76.8","M18.0","R19.7","Z23.","S05.02XA","Z21.","Z86.59","M79.672","M62.830","Z86.79","R63.4","M79.644","M79.641","F17.200","S60.940A","NO DATA","H53.9","M79.642","H04.123","H25.11","H25.12","H61.23","Z72.0","N83.209","N64.4","N83.201","B02.1","E87.6","F12.90","M43.6","D25.9","M19.90","R07.2","R05.","R06.02","R07.89","R53.1","R07.81","H53.149","B01.0","Z09.","S39.012A"],"date":["2021-08-04","2021-08-04","2021-04-07","2021-05-05","2021-10-05","2021-08-18","2021-10-05","2021-10-05","2020-12-08","2021-04-23","2021-02-04","2020-08-05","2020-08-05","2020-08-05","2020-08-05","2020-08-05","2021-02-01","2021-04-12","2020-04-20","2021-02-04","2021-02-04","2021-02-04","2021-02-04","2021-05-05","2021-05-05","2021-05-05","2021-05-27","2021-08-04","2019-06-22","2019-01-08","2019-01-22","2019-06-22","2019-06-22","2019-12-17","2019-06-22","2019-06-22","2019-06-22","2019-06-22","2019-06-22","2019-06-22","2019-06-22","2019-06-22","2019-06-22","2019-06-22","2019-06-23","2019-03-28","2019-11-09"],"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":[["","69452015120","VITAMIN","CAP 50000UNT","1","Select","Select",""],["","49702022813","TIVICAY","TAB 50MG","30","Select","Select",""],["","69238154401","HYDROXYCHLOR","TAB 200MG","30","Select","Select",""],["","61958210101","ODEFSEY","TAB ","30","Select","Select",""],["","59746017206","PREDNISONE","TAB 5MG","72","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","300","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","65162046510","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","64980051505","OFLOXACIN","DRO 0.3% OP","5","Select","Select",""],["","11822334910","RA","DRO 6.5% OT","15","Select","Select",""],["","00054455015","METHOTREXATE","TAB 2.5MG","16","Select","Select",""],["","69315012701","FOLIC","TAB 1000MCG","90","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","49348097310","PAIN","TAB 325MG","30","Select","Select",""],["","57896010101","NON-ASPIRIN","TAB 325MG","30","Select","Select",""],["","53746027201","SMZ\/TMP","TAB 800-160","15","Select","Select",""],["","65862019105","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","59762444002","METHYLPRED","TAB 4MG","21","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","15","Select","Select",""],["","68462019001","NAPROXEN","TAB 500MG","20","Select","Select",""],["","00378427693","VALACYCLOVIR","TAB 1GM","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":[]}},{"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":""}]}]}