{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRENDA   L WEST","gend":1,"add":"8 CARTER ST APT I9","city":"ONANCOCK","state":"VA","zip":"23417-9998","dob":"1969-06-20","age":"","mstatus":"","insh":"20037149*01","cliId":"","pno":"757\/387-7227","cno":"","email":"","ename":"","eno":"","pphy":"SNYDER JR, JOHN W MD","ppno":"757\/442-6600","pcpadd":"10085 WILLIAM F BERNART CIRCLE","pcpcity":"NASSAWADOX","pcpstate":"VA","pcpzip":23413,"pcpcounty":"","pcpid":"","pcpname":"Riverside Eastern Shore Family Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/442-3839","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I73.9","J30.1","J30.5","N95.0","R93.89","M54.12","M25.511","I10.","Z28.21","F41.1","J30.9","R20.2","NO DATA","M25.50","I51.7","R09.1","N89.8","Z01.419","N93.9","D25.9","R10.2","Z98.890","R07.89","Z20.822","K64.4","M54.10","R07.9","I49.9","R00.0","M25.561","M25.562","G89.29","G25.81","G62.9","T78.40XA","R94.31","I25.119","J45.20","Z87.891","E55.9","E66.3","Z68.29","Z12.11","Z86.2","Z71.3","K64.8","E78.5","F41.9","M19.90","Z79.899","Z88.1","Z88.0","G60.9","R19.5","R19.09","M25.532","M65.4","R30.0","N92.6","Z01.818","J45.909","Z13.220","R53.83","Z12.31","Z68.22","Z00.01","F41.8","Z12.4","R59.9","L29.9","K21.9","R01.1","Z87.2","R21.","Z13.6","Z13.228","R60.0"],"date":["2021-02-24","2022-09-27","2021-04-12","2021-09-15","2021-09-15","2020-11-30","2020-11-30","2022-09-09","2021-08-31","2021-08-31","2022-04-20","2020-10-13","2020-10-13","2020-10-13","2020-11-18","2020-10-13","2021-02-11","2021-03-25","2021-10-13","2021-03-25","2021-03-25","2021-09-15","2022-04-20","2021-08-16","2021-09-15","2020-10-07","2021-12-07","2021-08-17","2020-10-09","2020-11-11","2020-11-11","2020-11-11","2020-11-11","2020-01-09","2020-01-09","2021-08-17","2021-12-06","2022-08-19","2022-09-09","2021-08-31","2021-08-31","2021-08-31","2021-08-31","2022-08-19","2022-08-19","2021-09-07","2021-09-07","2021-09-07","2021-09-07","2021-09-07","2021-09-07","2021-09-07","2021-01-12","2021-02-16","2021-09-07","2020-01-22","2020-01-22","2021-02-11","2021-02-11","2021-08-16","2022-09-09","2019-04-25","2019-04-25","2022-08-19","2019-04-25","2019-05-24","2019-06-24","2019-05-24","2019-04-16","2019-04-16","2019-04-16","2019-04-16","2019-04-16","2019-04-16","2022-08-19","2022-08-19","2022-04-20"],"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":[["","00115169449","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","42571012290","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","43547040211","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","00378078205","FEXOFENADINE","TAB 180MG","30","Select","Select",""],["","49035099562","ALLERGY","TAB 180MG","90","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","30","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","16729020201","BUSPIRONE","TAB 10MG","60","Select","Select",""],["","68645055654","LISINOP\/HCTZ","TAB 10-12.5","30","Select","Select",""],["","65862019405","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","90","Select","Select",""],["","31604002612","IRON","TAB 325MG","180","Select","Select",""],["","81131009371","SV","TAB 325MG","60","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","31604004070","D3","TAB 1000UNIT","90","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","20555003400","FERROUS","TAB 325MG EC","90","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","41167035100","XYZAL","TAB 5MG","30","Select","Select",""],["","","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","","ASPERCREME","PAD LIDO 4%","","Select","Select",""],["","","LIDOCAINE","PAD 0.04","","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","","TRAMADOL","TAB 50MG","","Select","Select",""],["","","METHYLPRED","TAB 4MG","","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":""}]}]}