{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BARBARA   M PIPPEN","gend":1,"add":"1780 ACORN ST","city":"CHESAPEAKE","state":"VA","zip":"23324-9998","dob":"1959-11-25","age":"","mstatus":"","insh":"20039993*01","cliId":"","pno":"757\/319-0087","cno":"757\/462-0313","email":"","ename":"","eno":"","pphy":"LAPLACE, PETER MD","ppno":"757\/623-6072","pcpadd":"426 E FREEMASON ST","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23510","pcpcounty":"","pcpid":"","pcpname":"Associates in Primary Care, PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/623-9748","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M17.12","E78.2","I10.","E11.9","T86.841","Z96.652","L08.89","L60.0","L02.612","E11.42","L60.3","R20.2","L60.8","T86.8411","H26.491","H40.1133","D31.11","L00.","G89.18","V58.89","D75.1","H54.8","Q82.8","M85.80","E66.9","M10.9","K21.9","F41.9","Z72.0","H17.9","Z00.00","Z01.818","E78.00","M10.09","R74.9","Z01.419","Z12.4","M19.90","Z23.","D31.90","Z12.31","Z94.7","G25.81","E55.9","M17.11","T84.033A","H35.351","H21.1X1","R70.0","F17.210","R11.2","Z88.6","Z86.718","Z79.899","Z79.84","Z79.82","Z83.3","H04.123","Z01.810","Z01.811","Z01.812","R94.31","E11.40","B35.1"],"date":["2021-01-27","2020-03-06","2021-10-27","2021-01-07","2020-08-11","2021-01-27","2020-12-28","2021-12-30","2020-10-22","2021-12-30","2021-03-09","2021-12-30","2021-12-30","2021-09-20","2020-10-01","2021-09-20","2020-10-30","2020-12-28","2020-02-14","2020-03-06","2020-03-06","2020-03-06","2020-03-06","2020-03-06","2020-03-06","2020-03-06","2020-03-06","2020-03-06","2021-01-07","2020-06-19","2021-10-27","2021-10-27","2021-10-27","2021-10-27","2021-10-27","2021-10-27","2021-10-27","2021-10-27","2021-10-27","2021-10-27","2021-10-27","2020-10-07","2021-01-07","2021-01-07","2020-01-07","2020-02-13","2020-01-23","2020-06-29","2020-02-13","2020-02-13","2020-02-13","2020-02-13","2020-02-13","2020-02-13","2020-02-13","2020-02-13","2020-02-13","2020-06-29","2020-01-24","2020-01-24","2020-01-24","2020-01-24","2020-04-29","2020-07-29"],"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":[["","50742061710","METOPROL","TAB 100MG ER","30","Select","Select",""],["","00527163210","TRIAMT\/HCTZ","CAP 37.5-25","30","Select","Select",""],["","70727052925","ROCKLATAN","DRO ","2","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","61314014405","BRIMONIDINE","SOL 0.0015","5","Select","Select",""],["","60758011905","PREDNISOLONE","SUS 1% OP","5","Select","Select",""],["","61314064305","TOBRAMYCIN","SOL 0.3% OP","5","Select","Select",""],["","43547026810","ROPINIROLE","TAB 0.25MG","90","Select","Select",""],["","55111073005","ALLOPURINOL","TAB 300MG","30","Select","Select",""],["","74312052805","VITAMIN","TAB 1000MCG","30","Select","Select",""],["","17478021505","ATROPINE","SOL 1% OP","5","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","24","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","60505258008","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","00078090438","SIMBRINZA","SUS 1-0.2%","8","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","60505025103","TIZANIDINE","TAB 2MG","90","Select","Select",""],["","64980051415","TIMOLOL","SOL 0.5% OP","15","Select","Select",""],["","00525804990","METANX","CAP ","90","Select","Select",""],["","00023917705","ALPHAGAN","SOL 0.0015","5","Select","Select",""],["","76478000205","BETIMOL","SOL 0.005","5","Select","Select",""],["","68382075810","METFORMIN","TAB 500MG","360","Select","Select",""],["","00093321205","CLONAZEPAM","TAB 1MG","90","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","24208046325","LATANOPROST","SOL 0.00005","8","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":""}]}]}