{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RON   O HAWKINS","gend":0,"add":"25429 POPES STATION ROAD","city":"CAPRON","state":"VA","zip":"23829-9998","dob":"1969-06-16","age":"","mstatus":"","insh":"20054638*01","cliId":"","pno":"434\/378-4364","cno":"434\/378-4364","email":"","ename":"","eno":"","pphy":"COUNCIL, DELORIS NP","ppno":"757\/562-2158","pcpadd":"102 FAIRVIEW DR STE B","pcpcity":"FRANKLIN","pcpstate":"VA","pcpzip":23851,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/516-8019","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D50.8","D69.2","D72.818","K76.0","I10.","G43.109","K21.9","Z12.11","Z12.5","Z72.0","Z91.11","K92.2","D62.","D64.9","K86.0","E78.5","F10.10","K80.50","Z45.89","D69.6","S50.02XA","E78.2","Z79.899","F17.210","M25.522","K59.00","R94.5","K57.30","K64.8","K64.9","F32.9","R10.13","D50.0","K64.0","U07.1","NO DATA","E87.6","K85.90","K86.1","Z00.00","R17.","F10.230","R63.4","Z23.","F17.200","I81.","K64.4","Z88.8","Z90.49","Z83.3","Z82.49","F10.220","Z11.59","Z68.21","K75.0","R10.84","A41.9","N17.0","Z48.03","D50.9","Z79.2","Z03.818","K62.5","K83.5","T85.520A","Z46.59","R93.2","H25.13","Z87.19","L02.01","Z98.890","Z80.3","K85.20"],"date":["2022-03-02","2021-05-11","2021-05-11","2022-03-02","2022-09-24","2020-11-10","2022-09-24","2022-03-16","2020-11-10","2021-01-14","2020-11-10","2021-01-07","2020-12-25","2020-12-25","2021-05-06","2020-12-23","2022-03-02","2021-01-15","2021-01-15","2022-03-02","2022-09-24","2022-09-24","2022-09-24","2022-09-24","2022-09-24","2022-03-16","2021-02-08","2020-12-24","2020-12-25","2020-12-25","2020-12-25","2021-08-27","2020-12-24","2020-12-24","2021-03-22","2021-03-22","2021-06-12","2021-03-22","2022-03-16","2022-04-14","2021-05-06","2021-05-06","2021-05-06","2021-12-08","2022-03-16","2020-12-22","2020-12-22","2021-04-06","2020-12-22","2021-04-06","2021-04-06","2021-06-22","2022-04-14","2022-04-14","2020-08-19","2020-08-10","2020-08-19","2020-08-19","2020-08-19","2020-08-19","2020-08-19","2020-12-22","2020-12-25","2021-01-15","2021-01-15","2021-01-15","2021-01-15","2021-07-22","2021-01-14","2021-04-06","2021-04-06","2021-04-06","2021-06-12"],"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":[["","00456120330","LINZESS","CAP 72MCG","90","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","68645051054","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","00781286810","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00093505898","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","30","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","30","Select","Select",""],["","49281042150","FLUZONE","INJ 2021-22","0","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","5","Select","Select",""],["","68645019059","METOPROL","TAB 50MG","180","Select","Select",""],["","49281072010","FLUBLOK","INJ 2020-21","0","Select","Select",""],["","49035019402","EQ","DIS 21MG\/24H","90","Select","Select",""],["","68382060010","POT  CHLORIDE","TAB 10MEQ ER","6","Select","Select",""],["","12843003520","STOOL","CAP 100MG","30","Select","Select",""],["","63736003751","AMERICAINE","OIN 0.2","28","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":""}]}]}