{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANGELA   K SMITH","gend":1,"add":"101 DALE DR","city":"PORTSMOUTH","state":"VA","zip":"23704-9998","dob":"1969-10-09","age":"","mstatus":"","insh":"20041617*01","cliId":"","pno":"757\/305-6959","cno":"","email":"","ename":"","eno":"","pphy":"TANNOUS, GEORGE MD","ppno":"757\/673-5890","pcpadd":"SUITE 250 5818 HARBOR VIEW BLVD","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23435,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS MEDICAL ASSOCIATES","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":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R11.2","G44.89","U07.1","R78.81","E11.22","I12.0","N18.6","R53.83","T82.7XXA","Z99.2","Z68.23","D64.9","K92.2","I10.","Z68.24","R58.","Z01.812","Z20.822","Z01.818","T82.42XA","Z88.0","Z88.8","Z91.041","Z88.1","NO DATA","E83.51","D63.1","E87.1","N25.81","T85.79XA","B95.7","I70.8","Z79.899","Z79.891","E21.1","K62.5","E11.9","T82.898A","I44.4","D72.829","Z68.26","R57.9","D50.0","K29.70","M79.89","K57.31","D62.","Z86.16","Z87.01","Z91.15","K62.1","R19.7","Z79.1","K57.90","E11.3593","H25.11","Z96.1","Z98.42","H17.12","K57.30","D12.8","R42.","R06.02","N94.9","R57.8","T39.395A","E11.65","K86.89","K59.00","Z01.810","T82.868A","T82.9XXA","K92.1","I08.8","K52.9","D53.9","K25.9","K21.9","J81.0","Z03.818"],"date":["2021-04-13","2021-04-13","2021-09-08","2021-09-08","2022-10-07","2022-10-07","2022-10-09","2021-09-07","2021-09-07","2022-10-09","2022-10-09","2022-10-08","2022-10-10","2022-10-09","2021-12-21","2020-11-06","2021-07-06","2022-10-07","2021-07-06","2021-08-04","2021-08-04","2021-08-04","2021-08-04","2021-08-04","2021-09-03","2021-12-19","2022-10-07","2021-09-03","2021-12-19","2021-09-03","2021-09-03","2021-09-03","2022-10-07","2021-09-03","2021-09-08","2021-12-23","2021-12-15","2021-05-25","2021-09-03","2021-09-05","2021-09-05","2021-12-11","2022-10-09","2021-12-23","2021-08-26","2021-12-19","2021-12-20","2021-12-19","2021-12-19","2021-12-19","2021-12-22","2021-12-20","2021-12-20","2021-12-22","2021-04-29","2021-04-29","2021-04-29","2021-04-29","2021-04-29","2021-12-21","2021-12-21","2021-12-10","2021-12-10","2021-08-25","2021-12-11","2021-12-10","2022-10-08","2021-12-10","2021-12-10","2019-09-19","2019-09-19","2019-09-19","2022-10-08","2022-10-09","2022-10-07","2022-10-07","2022-10-07","2022-10-07","2022-10-09","2022-10-07"],"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":[["","68462010530","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","00781208102","CALC","CAP 667MG","360","Select","Select",""],["","31722052101","HYDRALAZINE","TAB 50MG","60","Select","Select",""],["","24979000901","NIFEDIPINE","TAB 90MG ER","60","Select","Select",""],["","00904530760","BANOPHEN","CAP 50MG","1","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","18","Select","Select",""],["","00054001925","PREDNISONE","TAB 50MG","3","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","30","Select","Select",""],["","11917009215","FERROUS","TAB 325MG","30","Select","Select",""],["","16729044010","CINACALCET","TAB 30MG","30","Select","Select",""],["","57664047758","METOPROL","TAB 50MG","60","Select","Select",""],["","00363010706","WAL-DRYL","CAP 25MG","2","Select","Select",""],["","","RENAGEL","TAB 800MG","","Select","Select",""],["","","SEVELAMER","TAB 800MG","","Select","Select",""],["","64380080907","IBUPROFEN","TAB 400MG","120","Select","Select",""],["","59746012106","MECLIZINE","TAB 25MG","30","Select","Select",""],["","45802058046","SCOPOLAMINE","DIS 1MG\/3DAY","10","Select","Select",""],["","53489012002","DOXYCYCL","TAB 100MG","20","Select","Select",""],["","16714089803","LORATADINE","TAB 10MG","30","Select","Select",""],["","69543025216","VIRTUSSIN","SOL 100-10\/5","118","Select","Select",""],["","69452020820","CALCITRIOL","CAP 0.5MCG","30","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","10","Select","Select",""],["","00378668977","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","","RENAL","CAP ","","Select","Select",""],["","00023587901","NEPHRO-VITE","TAB RX","30","Select","Select",""],["","65862014205","CARVEDILOL","TAB 3.125MG","60","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":""}]}]}