{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA  R SMITH","gend":1,"add":"PO BOX 1204","city":"NORFOLK","state":"VA","zip":23501,"dob":"1947-11-11","age":"","mstatus":"","insh":"20042740*01","cliId":"","pno":"757\/462-6456","cno":"","email":"","ename":"","eno":"","pphy":"Abdel Shaheed, Samir","ppno":"757\/623-0095","pcpadd":"3925 Portsmouth Boulevard","pcpcity":"Chesapeake","pcpstate":"VA","pcpzip":23501,"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":["K43.6","Z48.815","F41.9","E11.9","E78.00","I10.","E66.9","Z79.84","M19.90","S31.602A","M79.89","I82.411","I82.431","I82.412","M79.604","R10.9","R11.2","R53.1","N17.9","K56.7","N39.0","Z68.42","K55.8","R18.8","K57.92","E86.1","Z20.822","E78.5","E86.0","R00.0","E66.01","R33.9","E11.40","L60.3","L85.3","L60.0","H40.013","H40.053","H25.13","H52.4","I82.402","R60.1","K82.9","H25.813","M17.0","Z68.39","M25.561","M25.562","G89.29","R53.81","H90.0","H61.23"],"date":["2022-04-07","2021-11-30","2021-11-30","2022-07-28","2022-10-20","2022-10-20","2021-11-30","2021-11-30","2022-10-20","2021-11-01","2021-11-19","2021-12-27","2021-12-27","2021-11-19","2021-11-19","2021-09-16","2021-09-16","2021-10-07","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2022-08-31","2021-09-23","2019-06-24","2019-06-24","2019-06-24","2019-06-24","2019-08-12","2019-08-12","2019-08-12","2019-08-12","2022-09-06","2022-08-30","2022-09-09","2022-10-13","2022-08-31","2022-08-31","2022-09-01","2022-09-01","2022-09-01","2022-09-01","2022-09-29","2022-09-29"],"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":[["","68462026001","VERAPAMIL","TAB 240MG ER","60","Select","Select",""],["","67877056105","METFORMIN","TAB 500MG","60","Select","Select",""],["","13668011890","LOSARTAN\/HCT","TAB 100-25","90","Select","Select",""],["","50458058451","XARELTO","TAB 15\/20MG","51","Select","Select",""],["","16714043901","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","00093720198","PRAVASTATIN","TAB 20MG","90","Select","Select",""],["","00310620530","FARXIGA","TAB 5MG","30","Select","Select",""],["","00054429731","FUROSEMIDE","TAB 20MG","60","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","","HYDROCHLOROT","TAB 25MG","","Select","Select",""],["","16714071302","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","","LOSARTAN","TAB 100MG","","Select","Select",""],["","00093220301","METOCLOPRAM","TAB 10MG","90","Select","Select",""],["","16714001610","ENOXAPARIN","INJ 40\/0.4ML","24","Select","Select",""],["","65862005290","SIMVASTATIN","TAB 20MG","90","Select","Select",""],["","","VITAMIN","CAP 50000UNT","","Select","Select",""],["","45802049326","AMMONIUM","CRE 0.12","385","Select","Select",""],["","00023917705","ALPHAGAN","SOL 0.0015","5","Select","Select",""],["","61314014405","BRIMONIDINE","SOL 0.0015","5","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":""}]}]}