{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA ALLEN","gend":1,"add":"7903 W GLEN ROAD","city":"NORFOLK","state":"VA","zip":"23505-9998","dob":"1964-02-15","age":"","mstatus":"","insh":"20041650*01","cliId":"","pno":"757\/839-2418","cno":"","email":"","ename":"","eno":"","pphy":"PARKER, REBECCA M NP","ppno":"757\/689-8460","pcpadd":"SUITE 100 1925 GLENN MITCHELL DR","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23456,"pcpcounty":"","pcpid":"","pcpname":"Princess Anne Medical Associates","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/689-8435","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G89.4","M47.896","M54.42","M53.3","G89.29","S16.1XXA","S00.83XA","M25.551","M54.5","M25.511","Z98.1","J30.9","F41.9","M47.814","M47.816","Z20.822","M54.16","M96.1","M43.06","M51.36","M62.838","M99.04","F39.","L03.90","M46.1","Z79.899","NO DATA","Z01.818","G89.11","S13.4XXA","J45.909","K21.9","M25.50","M54.41","M51.34","M19.90","M19.049","G62.9","Z20.828","Z00.00","E55.9","Z13.220","F32.9","F43.12","J01.00","Z53.20"],"date":["2021-12-08","2021-07-28","2020-10-07","2021-06-17","2020-10-07","2019-10-26","2019-10-26","2019-10-26","2020-10-05","2019-10-26","2021-07-07","2021-12-09","2021-12-09","2021-05-18","2021-07-26","2021-07-26","2021-11-04","2021-12-08","2021-07-28","2020-07-22","2020-07-22","2019-03-12","2019-06-11","2019-07-23","2020-07-22","2021-06-17","2021-12-09","2021-07-19","2019-12-28","2019-12-28","2019-12-28","2019-12-28","2021-12-09","2020-10-07","2021-10-06","2019-11-04","2020-06-19","2020-06-19","2021-01-29","2021-12-09","2021-12-09","2021-12-09","2021-12-09","2021-01-12","2021-02-11","2021-08-14"],"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":[["","53489011905","DOXYCYCL","CAP 100MG","10","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","30","Select","Select",""],["","","GABAPENTIN"," GABAPENTIN ","60","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","","VITAMIN"," VITAMIN ","8","Select","Select",""],["","59779045839","CVS","TAB 10MG","30","Select","Select",""],["","","TRAMADOL","TAB 50MG","","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","21","Select","Select",""],["","","TIZANIDINE"," TIZANIDINE ","90","Select","Select",""],["","","CELECOXIB","CAP 100MG","","Select","Select",""],["","00409121501","NALOXONE","INJ 0.4MG\/ML","1","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","8","Select","Select",""],["","","SERTRALINE"," SERTRALINE ","30","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","","PREDNISONE","TAB 20MG","","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","","PROVENTIL","AER HFA","","Select","Select",""],["","","ACETAMINOPHN","TAB 500MG","","Select","Select",""],["","","METHOCARBAM","TAB 750MG","","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":""}]}]}