{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EARLINE   T BOONE","gend":1,"add":"115 E 41ST APT B5","city":"NORFOLK","state":"VA","zip":"23504-9998","dob":"1946-07-12","age":"","mstatus":"","insh":"20041514*01","cliId":"","pno":"757\/748-0634","cno":"757\/287-6859","email":"","ename":"","eno":"","pphy":"BEVERLY, VERNIS MD","ppno":"757\/623-0095","pcpadd":"SUITE 1 1401 TIDEWATER DR","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23504,"pcpcounty":"","pcpid":"","pcpname":"Adult and Pediatric Medical Associates","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/623-1203","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J45.909","I10.","F33.3","S09.90XA","S69.92XA","W01.0XXA","B20.","M20.10","M20.40","B35.1","M79.676","I25.10","R26.89","R11.2","R10.9","S90.121A","M79.674","M43.16","M51.16","T14.90XA","F31.9","R63.6","R79.89","M79.671","M20.41","M20.42","M20.11","M20.12","R19.7","R10.84","M21.619","M79.672","Z23.","R55.","N30.00","Z11.59","Z88.1","Z91.018","Z88.0","Z86.59","T78.40XA","S90.111A","NO DATA","Z00.00","H90.0","H61.893","H61.23","Z96.1","R05.","Z20.828","E78.5"],"date":["2021-11-04","2021-11-04","2021-10-01","2021-09-16","2021-09-16","2021-09-16","2021-11-04","2020-08-28","2019-01-23","2020-02-12","2019-01-23","2019-09-20","2019-09-20","2020-10-19","2020-10-19","2021-04-20","2021-04-20","2019-06-03","2019-06-03","2020-10-27","2021-03-29","2021-03-29","2021-01-27","2021-07-09","2020-08-28","2020-08-28","2020-02-12","2020-02-12","2020-07-07","2020-03-08","2020-08-28","2020-08-28","2019-09-12","2019-12-02","2020-07-07","2020-07-07","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2020-08-20","2020-08-20","2021-03-29","2019-04-24","2019-05-30","2019-05-30","2019-05-30","2019-08-16","2020-08-24","2020-08-24","2021-08-26"],"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":[]},{"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":[["","61958250101","BIKTARVY","TAB ","30","Select","Select",""],["","43547035410","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","45802065065","LORATADINE","TAB 10MG","30","Select","Select",""],["","00378875006","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","59676056201","PREZISTA","TAB 600MG","60","Select","Select",""],["","65862001130","SERTRALINE","TAB 25MG","30","Select","Select",""],["","49348081845","SM","TAB 10MG","30","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","55111012290","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","100","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","00093816601","QUETIAPINE","TAB 50MG","30","Select","Select",""],["","50228046501","NABUMETONE","TAB 500MG","30","Select","Select",""],["","31722070190","LOSARTAN","TAB 50MG","30","Select","Select",""],["","70436005801","BUPROPION","TAB 100MG SR","30","Select","Select",""],["","69097015807","MELOXICAM","TAB 7.5MG","30","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00074333330","NORVIR","TAB 100MG","60","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","00093031101","LOPERAMIDE","CAP 2MG","60","Select","Select",""],["","11822318460","ANTI-DIARRHE","TAB 2MG","30","Select","Select",""],["","35573040230","ABACA\/LAMIVU","TAB 600-300","30","Select","Select",""],["","00054040713","RITONAVIR","TAB 100MG","60","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","60","Select","Select",""],["","60505327503","OLANZAPINE","TAB 5MG ODT","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","14","Select","Select",""],["","49483060350","IBUPROFEN","TAB 600MG","15","Select","Select",""],["","10702001150","HYDROXYZ","TAB 25MG","10","Select","Select",""],["","00172392670","DIAZEPAM","TAB 5MG","3","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":""}]}]}