{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"STEPHANIE  N GADD","gend":1,"add":"1281 SWALLOW DR","city":"VIRGINIA BEACH","state":"VA","zip":23453,"dob":"1989-09-01","age":"","mstatus":"","insh":"20041232*01","cliId":"","pno":"757\/574-2425","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"757\/955-2828","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23453,"pcpcounty":"","pcpid":"","pcpname":"AMELIA MEDICAL ASSOCIATES","plan":"OHP","program":"Medicaid","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/955-2829","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.3","F41.9","F60.3","V62.89","F41.1","F33.1","Z65.8","V62.84","F12.99","F10.99","F33.41","F33.0","F60.4","K29.50","K22.8","K44.9","R42.","E11.65","F17.210","R10.13","R10.11","K21.9","R13.14","R11.0","E11.9","R73.09","N89.8","E11.69","N76.0","B96.89","F32.9","Z20.822","F43.23","NO DATA","F43.10","F17.200","N32.81","E66.01","S30.861A","R53.83","R51.","S76.911A","Z71.2","Z87.448","K29.60","K22.70","H92.09","M79.601","R73.9","Z72.0","E66.9","Z79.84","Z91.038","R40.0","Z01.411","N92.1","E28.2","B37.3","N31.9","Z32.02","R07.89","Z62.810","Z56.9","Z62.820","Z30.013","Z30.46","Z30.42","R07.9","R06.02","F17.290","Z82.49","N76.89","R82.998","M72.2","M76.62","F32.3"],"date":["2022-08-29","2022-08-29","2022-08-29","2021-05-21","2021-05-21","2021-08-18","2022-08-24","2021-05-21","2022-08-29","2022-06-08","2021-07-21","2020-09-16","2022-10-11","2020-05-11","2020-05-11","2020-07-16","2022-09-24","2022-09-24","2022-09-24","2020-11-11","2020-05-07","2020-05-07","2020-05-07","2020-05-07","2022-05-12","2020-08-03","2021-01-04","2021-05-19","2022-04-18","2021-01-04","2021-05-21","2021-04-01","2021-05-21","2021-05-21","2022-11-10","2021-05-21","2020-02-20","2020-02-20","2020-07-07","2021-01-05","2020-07-07","2020-07-26","2021-01-05","2020-02-06","2020-05-11","2020-05-11","2020-02-05","2021-07-21","2020-08-03","2020-11-11","2022-05-12","2022-09-24","2022-09-24","2022-09-24","2022-05-12","2022-05-12","2022-05-12","2022-05-12","2022-05-12","2022-06-14","2022-05-07","2022-08-24","2022-08-24","2022-08-24","2022-06-14","2022-06-14","2022-09-06","2022-05-07","2022-05-07","2022-05-07","2022-05-07","2022-02-04","2022-02-04","2022-11-01","2022-11-01","2022-08-02"],"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":[["","65862019301","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","29300022701","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","51224022060","METFORMIN","TAB 1000MG","60","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","50","Select","Select",""],["","23155050101","HYDROXYZ","TAB 25MG","90","Select","Select",""],["","68462011944","FLUCONAZOLE","TAB 150MG","3","Select","Select",""],["","51672127502","CLOTRIMAZOLE","CRE 0.01","30","Select","Select",""],["","00002143380","TRULICITY","INJ 0.75\/0.5","2","Select","Select",""],["","53885004401","ONE","KIT VERIO FL","1","Select","Select",""],["","50458056301","INVEGA","INJ 156MG\/ML","1","Select","Select",""],["","65162019010","NAPROXEN","TAB 500MG","20","Select","Select",""],["","59746002022","RISPERIDONE","TAB 1MG ODT","28","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","00378641001","DOXEPIN","CAP 100MG","30","Select","Select",""],["","00378397993","PALIPERIDONE","TAB ER 3MG","30","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","15","Select","Select",""],["","31722082030","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","61874011530","VRAYLAR","CAP 1.5MG","30","Select","Select",""],["","55111015901","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","00527128201","DICYCLOMINE","TAB 20MG","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":{"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":""}]}]}