{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"FREDERICK MARTIN II","gend":0,"add":"41 REDON DR","city":"HAMPTON","state":"VA","zip":"23666-9998","dob":"1988-10-18","age":"","mstatus":"","insh":"20063399*01","cliId":"","pno":"757\/329-7568","cno":"","email":"","ename":"","eno":"","pphy":"WENG, JESSICA MD","ppno":"757\/850-1311","pcpadd":"19D FOX HILL RD","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":23669,"pcpcounty":"","pcpid":"","pcpname":"RIVERSIDE PHYSICIAN SERVICES INC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/850-7315","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Q23.4","Z95.810","Z00.00","Z23.","Z68.32","F17.210","A63.0","M54.5","I47.2","Z45.018","Z03.89","Q20.4","I50.1","I47.1","E66.9","Z68.34","Z71.6","Z79.82","Z79.899","Z98.890","I48.3","NO DATA","G89.29","I45.81","I45.10","I51.7","Z51.81","I49.9","B49.","R05.9","Z72.0","I45.19","M62.830","F10.10","R63.5","Z87.74","M43.16","M47.816","M51.36","M51.37","K02.9","K08.89","Z95.0","R23.0","K76.9","I51.89","R05.","Z87.898","Z95.818","T82.190A","R94.31","Z68.36","Z71.9","H66.91","L03.011","I51.4","K05.00"],"date":["2022-10-19","2022-03-02","2021-12-20","2020-11-13","2020-11-13","2021-09-22","2022-10-12","2021-08-02","2022-05-25","2021-02-19","2020-07-01","2022-10-19","2022-10-19","2022-10-19","2022-03-02","2021-09-22","2021-09-22","2022-03-02","2022-03-02","2021-09-22","2021-09-22","2022-10-19","2022-05-26","2020-03-13","2022-01-12","2022-05-25","2020-03-13","2020-03-13","2020-12-07","2021-12-10","2022-04-30","2022-05-25","2021-08-11","2022-03-02","2021-01-27","2020-10-28","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2020-01-07","2020-01-07","2020-08-07","2021-01-27","2021-01-27","2021-01-27","2021-01-27","2021-01-27","2022-03-02","2022-01-12","2022-01-12","2022-03-02","2022-10-12","2022-04-30","2022-07-20","2022-03-02","2022-07-06"],"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":[["","52817033010","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","43598044774","NICOTINE","DIS 14MG\/24H","28","Select","Select",""],["","60505008100","SOTALOL","TAB 160MG","10","Select","Select",""],["","00536100836","ASPIRIN","CHW 81MG","30","Select","Select",""],["","65862020299","LOSARTAN","TAB 50MG","30","Select","Select",""],["","75834002012","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","51991087733","EPLERENONE","TAB 25MG","90","Select","Select",""],["","65862064169","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","65862001705","AMOXICILLIN","CAP 500MG","28","Select","Select",""],["","00093227434","AMOX\/K","TAB 500-125","20","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","15","Select","Select",""],["","45802036853","IMIQUIMOD","CRE 0.05","12","Select","Select",""],["","53746051105","SPIRONOLACT","TAB 25MG","60","Select","Select",""],["","00363021879","ASPIRIN-81","CHW 81MG","30","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","15","Select","Select",""],["","57237004105","PENICILLN","TAB 500MG","28","Select","Select",""],["","00406012405","HYDROCO\/APAP","TAB 7.5-325","15","Select","Select",""],["","00168009930","KETOCONAZOLE","CRE 0.02","30","Select","Select",""],["","58160088552","FLUARIX","INJ 2020-21","0","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":""}]}]}