{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAVID KENDALL","gend":0,"add":"7440 FENNER ST APT 4","city":"NORFOLK","state":"VA","zip":"23505-9998","dob":"1958-12-12","age":"","mstatus":"","insh":"20046241*01","cliId":"","pno":"757\/627-8686","cno":"","email":"","ename":"","eno":"","pphy":"VILLATE PRIETO, SUSANA MD","ppno":"757\/278-2240","pcpadd":"155 KINGSLEY LN STE 400","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23505,"pcpcounty":"","pcpid":"","pcpname":"DEPAUL MEDICAL ASSOCIATES","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/489-6469","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J44.1","J96.21","J96.22","R09.02","J96.11","Z11.59","E55.9","E78.2","J44.9","J41.8","J43.1","R91.8","F17.211","F41.9","G25.0","J96.01","J96.02","J43.9","F41.8","R06.89","J47.1","R73.01","Z68.27","J84.9","E78.5","Z99.81","F32.9","F10.21","Z79.51","Z79.52","Z79.899","Z90.49","Z87.01","Z87.891","A41.9","R91.1","Z12.11","Z23.","J47.9"],"date":["2021-12-29","2021-09-02","2021-12-29","2021-09-02","2021-11-04","2020-06-30","2021-07-17","2021-11-30","2021-11-30","2021-05-05","2021-11-04","2021-11-04","2021-11-04","2021-11-08","2021-07-17","2021-07-22","2021-07-22","2021-07-21","2021-07-22","2021-07-22","2021-07-20","2019-06-21","2019-06-21","2021-07-17","2021-07-17","2021-07-17","2021-07-17","2021-07-17","2021-07-17","2021-07-17","2021-07-17","2021-07-17","2021-07-17","2021-07-17","2021-07-18","2019-03-20","2021-11-08","2021-11-04","2021-11-04"],"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":[["","","PROAIR"," PROAIR ","8","Select","Select",""],["","","PROPRANOLOL"," PROPRANOLOL ","60","Select","Select",""],["","","SERTRALINE"," SERTRALINE ","30","Select","Select",""],["","","SPIRIVA"," SPIRIVA ","30","Select","Select",""],["","","IPRATROPIUM\/"," IPRATROPIUM\/ ","270","Select","Select",""],["","","VENTOLIN"," VENTOLIN ","18","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","8","Select","Select",""],["","","VITAMIN"," VITAMIN ","4","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","30","Select","Select",""],["","","OPTIMAL-D"," OPTIMAL-D ","4","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","5","Select","Select",""],["","","ADVAIR"," ADVAIR ","12","Select","Select",""],["","","FLUTIC\/SALME","AER 250\/50","","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":""}]}]}