{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRUCE HARVEY","gend":0,"add":"3132 BISCAYNE DR","city":"CHESAPEAKE","state":"VA","zip":"23321-9998","dob":"1962-06-19","age":"","mstatus":"","insh":"20059720*01","cliId":"","pno":"757\/995-9018","cno":"757\/995-9018","email":"","ename":"","eno":"","pphy":"MAPANAO, VIVIAN MD","ppno":"757\/483-7100","pcpadd":"Bridge Road Family Medicine 4868 Br","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23435,"pcpcounty":"","pcpid":"","pcpname":"Bridge Road Family Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/483-7150","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H25.13","K52.9","R51.","J44.9","N40.0","R19.7","K92.1","R19.07","F17.200","F10.10","F33.2","K52.832","K63.5","R74.8","F43.9","I87.2","M79.606","H43.392","I45.19","F10.20","J20.9","M79.605","J44.1","Z72.89","F41.8","M79.631","J98.4","Z79.899","M79.89","F10.929","F32.9","R07.89","Z86.010","K62.1","R60.0","R06.02","E53.8","E55.9","G31.84","M54.2","M54.5","E78.5","E03.9","K21.9","R73.02","R03.0","M79.601","S09.90XS","Z68.33","K76.0","E66.9","F51.01","M54.40","Z68.34","R73.09","S00.83XA","H11.32","H53.8","Y04.8XXA","R94.5","S05.12XA","E05.90","G62.9","K62.5","M54.10","R51.9","F99.","Z00.8","Z72.0","F12.20","F60.3","J45.909","G47.00","F17.210","Z59.02","M51.36","G57.91","R73.03","J06.9","K64.9"],"date":["2020-05-08","2020-05-19","2020-05-19","2021-10-09","2021-10-05","2021-06-07","2020-06-11","2020-06-11","2021-10-28","2021-04-14","2021-10-12","2021-06-07","2021-02-10","2021-07-07","2021-03-02","2021-07-08","2021-07-08","2021-09-02","2021-10-28","2022-04-20","2021-06-04","2021-07-08","2021-06-04","2021-06-04","2021-06-04","2021-10-04","2021-10-04","2021-10-04","2021-10-04","2021-10-28","2022-02-01","2021-10-28","2021-06-07","2021-02-10","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2021-10-05","2021-10-05","2021-07-07","2021-07-07","2021-10-05","2021-10-09","2020-07-09","2020-05-19","2020-12-30","2021-06-07","2020-08-24","2020-08-24","2020-08-24","2020-09-03","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2020-06-03","2021-08-13","2020-12-04","2020-12-04","2020-12-04","2020-12-04","2020-12-04","2021-10-04","2021-10-04","2021-10-04","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-10-05"],"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":[["","60505024701","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","00093005301","BUSPIRONE","TAB 5MG","60","Select","Select",""],["","69784018010","POLYETH","POW 3350 NF","14","Select","Select",""],["","00093112201","ETODOLAC","TAB 400MG","20","Select","Select",""],["","72305002530","EUTHYROX","TAB 25MCG","30","Select","Select",""],["","51862058001","BUDESONIDE","CAP 3MG DR","90","Select","Select",""],["","51672126302","NYSTAT\/TRIAM","CRE ","60","Select","Select",""],["","00487020103","IPRATROPIUM\/","SOL ALBUTER","90","Select","Select",""],["","59310057922","PROAIR","AER ","26","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","31","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","90","Select","Select",""],["","50111078710","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","72205000390","ROSUVASTATIN","TAB 10MG","90","Select","Select",""],["","00904113213","VITAMIN","TAB 100MCG","90","Select","Select",""],["","50111043301","TRAZODONE","TAB 50MG","30","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","18","Select","Select",""],["","47781064090","LEVOTHYROXIN","TAB 25MCG","14","Select","Select",""],["","43547028111","ESCITALOPRAM","TAB 10MG","14","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","26","Select","Select",""],["","65649040001","PLENVU","SOL ","3","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","3","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","Select","Select",""],["","35046001130","B-12","SUB 1000MCG","90","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","31","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":""}]}]}