{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MICHAEL MCLANE","gend":0,"add":"9324 FIRST VIEW ST APT 9","city":"NORFOLK","state":"VA","zip":"23503-9998","dob":"1958-02-04","age":"","mstatus":"","insh":"20052496*01","cliId":"","pno":"757\/502-3132","cno":"757\/502-3132","email":"","ename":"","eno":"","pphy":"MARKOVIC, VLADIMIR MD","ppno":"757\/533-9108","pcpadd":"3415 GRANBY STREET","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23504,"pcpcounty":"","pcpid":"","pcpname":"Hampton Roads Community Health Center","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/622-6384","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z45.2","T30.0","T14.90XA","R69.","R40.20","R20.0","M25.511","S01.81XA","G47.00","I10.","F41.9","G40.909","J44.9","Z00.00","F17.219","E55.9","R52.","R53.83","F43.10","E87.1","M65.9","Z72.0","F10.20","M86.9","M00.041","S61.254A","S61.250A","M65.141","L02.511","B95.62","F17.210","E86.0","Z79.899","M00.9","F10.10","R56.9","M79.644","M25.641","M25.441","M95.8","S22.32XA","V09.3XXA","R55.","M65.849","E87.0","S69.91XA","R20.2","L08.89","M65.841","Z13.1","Z13.220","Z12.11","S62.001A"],"date":["2020-03-26","2020-05-26","2021-07-04","2020-11-24","2021-07-05","2021-07-05","2021-07-05","2021-07-05","2021-11-24","2022-05-24","2022-05-24","2021-11-24","2022-05-24","2021-11-24","2022-05-24","2022-05-24","2022-01-07","2022-05-24","2022-05-24","2020-04-01","2020-03-27","2020-04-08","2020-03-22","2020-03-25","2020-03-22","2020-03-23","2020-03-22","2020-03-22","2020-04-01","2020-03-22","2020-03-22","2022-05-26","2020-03-22","2020-04-08","2020-04-08","2020-09-21","2020-04-21","2020-04-21","2020-04-21","2020-04-21","2020-11-25","2020-11-25","2022-05-26","2020-05-02","2020-05-02","2022-01-07","2022-01-07","2020-03-23","2020-03-23","2020-09-21","2020-09-21","2020-09-21","2022-01-07"],"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":[]},{"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":[["","42858010250","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","00186037220","SYMBICORT","AER 80-4.5","10","Select","Select",""],["","23155050101","HYDROXYZ","TAB 25MG","60","Select","Select",""],["","43547035410","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","59310057922","PROAIR","AER ","26","Select","Select",""],["","65862037401","ESCITALOPRAM","TAB 10MG","90","Select","Select",""],["","51672413204","LAMOTRIGINE","TAB 150MG","180","Select","Select",""],["","11822549870","VITAMIN","CAP 5000UNIT","30","Select","Select",""],["","00310737220","BUDES\/FORMOT","AER 80-4.5","10","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","68180051901","LISINOP\/HCTZ","TAB 20-12.5","60","Select","Select",""],["","00378320501","PRAZOSIN","CAP 5MG","30","Select","Select",""],["","65862059801","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","11822033670","RA","TAB 100MG","14","Select","Select",""],["","10135013201","THIAMINE","TAB 100MG","14","Select","Select",""],["","67877019805","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","31722094101","HYDROCO\/APAP","TAB 5-325MG","8","Select","Select",""],["","68382005101","MELOXICAM","TAB 15MG","30","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","10702001850","OXYCODONE","TAB 5MG","15","Select","Select",""],["","41167005840","ASPERCREME","PAD LIDO 4%","10","Select","Select",""],["","70677005801","SM","TAB 8.6MG","20","Select","Select",""],["","69547035302","NARCAN","SPR ","2","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":""}]}]}