{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JUAN  A DIGGS","gend":0,"add":"3243 MANOR GLENN CT","city":"VIRGINIA BEACH","state":"VA","zip":23453,"dob":"1960-09-10","age":"","mstatus":"","insh":"20040583*01","cliId":"","pno":"757\/689-2256","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"757\/627-6892","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23453,"pcpcounty":"","pcpid":"","pcpname":"Primary Care Specialists","plan":"OHP","program":"Medicaid","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/627-5809","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.30","V58.89","G47.33","M16.11","Z68.32","I48.0","I51.7","I10.","I11.9","R01.1","R94.31","E78.00","E11.9","Z68.33","E78.5","M10.9","Z68.31","Z12.5","R60.0","I48.91","N52.9","S02.5XXA","R51.","M54.2","Z20.828","S33.5XXA","S40.011A","Z68.30","R06.89","Z79.899","M70.52","J06.9","R73.03"],"date":["2022-04-22","2019-05-28","2022-11-08","2021-10-25","2021-10-25","2022-04-29","2022-04-22","2022-04-22","2022-04-22","2022-04-22","2022-04-22","2022-04-22","2021-10-25","2020-12-07","2021-10-25","2021-10-25","2020-08-04","2021-10-25","2019-11-13","2021-10-25","2021-10-25","2019-04-20","2019-04-20","2019-04-20","2021-01-22","2021-03-16","2021-03-16","2019-01-24","2019-04-04","2019-04-04","2019-10-30","2019-03-11","2022-01-07"],"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":[["","","METFORMIN"," METFORMIN ","30","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","180","Select","Select",""],["","70010000201","COLCHICINE","TAB 0.6MG","15","Select","Select",""],["","","HYDROCHLOROT","TAB 12.5MG","","Select","Select",""],["","","LISINOPRIL","TAB 20MG","","Select","Select",""],["","","SIMVASTATIN"," SIMVASTATIN ","30","Select","Select",""],["","69584084110","SOTALOL","TAB 80MG","60","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","15","Select","Select",""],["","27241006910","SILDENAFIL","TAB 100MG","10","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","49281042150","FLUZONE","INJ 2021-22","0","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","30","Select","Select",""],["","00006483703","PNEUMOVAX","INJ 25\/0.5","0","Select","Select",""],["","58160081552","TWINRIX","INJ ","1","Select","Select",""],["","10702000709","CYCLOBENZAPR","TAB 10MG","20","Select","Select",""],["","31722054301","INDOMETHACIN","CAP 50MG","15","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","68645055754","LISINOP\/HCTZ","TAB 20-12.5","30","Select","Select",""],["","","FLUBLOK","INJ 2020-21","","Select","Select",""],["","","DICLOFENAC","TAB 75MG DR","","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}