{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CARMELA EREN","gend":1,"add":"3810 CLIFFORD ST","city":"PORTSMOUTH","state":"VA","zip":"23707-9998","dob":"1971-05-10","age":"","mstatus":"","insh":"20039181*01","cliId":"","pno":"757\/309-0009","cno":"757\/291-5820","email":"","ename":"","eno":"","pphy":"SHAH, MEGHANA R MD","ppno":"757\/673-5890","pcpadd":"5818 HARBOUR VIEW BLVD STE 250","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23435,"pcpcounty":"","pcpid":"","pcpname":"HARBOUR VIEW FAMILY PRACTICE","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/484-7052","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.2","F31.9","F33.3","K11.21","F60.3","F43.12","Z01.419","I10.","Z68.42","E61.1","F17.200","Z87.09","F32.89","R73.01","E66.01","Z12.11","M54.32","Z68.43","F41.1","Z86.59","F25.9","F51.01","F33.1","H35.373","R59.0","E78.5","N95.9","R71.8","F41.9","R79.89","Z03.818","Z11.59","F32.9","D64.9","F25.0","F33.9","J06.9","F17.210","Z72.0","E66.9","R73.03","M54.42","E11.9","Z88.6","Z88.8","Z79.899","M54.9","R10.9","D50.0","E88.81","M54.5","M54.16","J18.9","J45.41","J45.20"],"date":["2021-12-31","2020-11-19","2021-10-17","2021-01-04","2021-12-31","2021-04-23","2021-03-09","2021-09-08","2021-12-08","2021-10-19","2021-10-19","2021-09-08","2021-09-08","2021-10-19","2021-07-09","2021-09-08","2021-07-09","2021-07-09","2021-12-31","2020-07-13","2021-04-12","2021-04-12","2021-11-04","2021-01-14","2021-01-20","2021-10-19","2021-01-20","2021-10-19","2021-10-19","2021-10-19","2020-09-04","2020-09-04","2020-06-04","2021-12-08","2020-06-27","2020-06-27","2021-08-21","2021-09-08","2019-03-25","2019-03-25","2019-01-07","2019-09-20","2019-09-20","2019-09-20","2019-09-20","2019-09-20","2019-09-20","2019-09-09","2019-03-25","2019-03-25","2019-12-11","2019-09-25","2019-03-21","2019-03-21","2019-10-25"],"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":[["","69097083412","SERTRALINE","TAB 50MG","30","Select","Select",""],["","23155000810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","68382002310","ATENOLOL","TAB 50MG","90","Select","Select",""],["","65862020390","LOSARTAN","TAB 100MG","30","Select","Select",""],["","","FERROUS","TAB 325MG EC","","Select","Select",""],["","00093227434","AMOX\/K","TAB 500-125","20","Select","Select",""],["","00456240260","SAPHRIS","SUB 2.5MG","30","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","500","Select","Select",""],["","50111043301","TRAZODONE","TAB 50MG","30","Select","Select",""],["","68180021609","LOSARTAN\/HCT","TAB 100-12.5","90","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","00378932132","WIXELA","AER 250\/50","60","Select","Select",""],["","70710122600","AMITRIPTYLIN","TAB 25MG","60","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","49884093547","DICLOFENAC","GEL 0.01","500","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","49999090885","PROAIR","AER ","8","Select","Select",""],["","00591544310","PREDNISONE","TAB 20MG","21","Select","Select",""],["","00143314205","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","20","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","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":""}]}]}