{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHERRY ALSTON","gend":1,"add":"910 ANN ST APT 1","city":"PORTSMOUTH","state":"VA","zip":"23704-9998","dob":"1964-06-16","age":"","mstatus":"","insh":"20049731*01","cliId":"","pno":"757\/776-7017","cno":"","email":"","ename":"","eno":"","pphy":"REINEKE-PIPER, KRISTEN MD","ppno":"757\/488-3333","pcpadd":"3925 PORTSMOUTH BLVD","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23321,"pcpcounty":"","pcpid":"","pcpname":"Family Medicine Health Care","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/488-0007","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.60","E78.5","E11.8","R06.02","M17.11","M25.561","M25.661","G89.29","Z68.41","N62.","R06.9","R05.","L30.9","Z20.828","R43.9","J44.9","R09.89","E11.9","I10.","Z87.891","Z88.6","Z88.5","Z88.8","M54.9","E11.40","E55.9","E66.9","F31.30","L90.5","M10.9","Z23.","F41.9","D64.9","M25.562","M54.5","Z01.419","N76.0","Z12.4","M79.89","M79.606","F31.10","Z98.890","S61.012A","S89.91XA","K21.9","E66.01","E78.00","G47.30","M19.90","Z79.1","Z79.52","Z79.84","Z79.899","Z68.37","J45.30","G47.33","R91.1","F17.200","Z01.811","M65.4","M79.642","S39.012A","Z01.818","R07.9","D31.60","S39.92XA","R07.89"],"date":["2021-09-09","2021-02-09","2020-01-22","2020-07-14","2021-06-25","2021-11-02","2021-06-25","2021-07-23","2021-06-25","2020-01-29","2020-03-30","2020-07-14","2020-07-14","2020-07-14","2020-07-14","2021-09-13","2020-07-14","2021-11-03","2021-09-13","2021-09-13","2020-07-14","2020-07-14","2020-07-14","2021-07-23","2021-07-23","2020-09-18","2021-07-23","2021-09-07","2020-05-26","2021-11-02","2021-11-02","2021-11-02","2021-06-30","2021-06-30","2021-06-04","2021-06-11","2021-06-11","2021-06-11","2021-11-03","2021-11-03","2021-07-23","2020-10-06","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2019-05-15","2019-05-15","2019-05-15","2019-05-15","2019-05-15","2019-05-21","2019-05-07","2019-07-24","2019-05-16","2019-08-21","2019-12-20","2019-07-24","2019-08-21"],"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":[["","16729013401","ALLOPURINOL","TAB 100MG","30","Select","Select",""],["","70010049101","METFORMIN","TAB 500MG ER","30","Select","Select",""],["","43547035310","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","68180063809","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","16571020110","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","00310621030","FARXIGA","TAB 10MG","90","Select","Select",""],["","23155065105","METRONIDAZOL","TAB 250MG","14","Select","Select",""],["","70010010801","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","29300014901","QUETIAPINE","TAB 100MG","30","Select","Select",""],["","67877019905","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","70436001104","BUPROPN","TAB 300MG XL","30","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","90","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","64380071206","BENZONATATE","CAP 100MG","21","Select","Select",""],["","69315012701","FOLIC","TAB 1000MCG","30","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","00002143380","TRULICITY","INJ 0.75\/0.5","2","Select","Select",""],["","62332025118","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","70010013901","NAPROXEN","TAB 500MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","72647033104","METHYLPRED","TAB 4MG","21","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":""}]}]}