{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ALICE BROWN","gend":1,"add":"2954 SEMINOLE ST","city":"HAYES","state":"VA","zip":"23072-9998","dob":"1960-03-29","age":"","mstatus":"","insh":"20063984*01","cliId":"","pno":"757\/585-9833","cno":"757\/585-9833","email":"","ename":"","eno":"","pphy":"STONE, ERIC B MD","ppno":"804\/642-6171","pcpadd":"2246 GEORGE WASHINGTON MEMORIAL HIG","pcpcity":"HAYES","pcpstate":"VA","pcpzip":23072,"pcpcounty":"","pcpid":"","pcpname":"Hayes Medical Center","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/642-5656","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z20.822","I10.","D24.1","F33.2","E78.5","F41.8","R61.","Z87.898","E03.8","Z23.","NO DATA","R73.9","E04.0","R53.83","E61.1","Z20.828","R30.0","R39.15","E11.8","N60.01","N60.02","R40.0","E66.3","G47.00","D24.2","F41.9","Z03.818","R82.90","E78.49","Z71.89","N30.01","E03.9","E04.9","Z85.3","G89.29","R29.898","R29.2","M17.0","M51.36","R26.81"],"date":["2021-03-25","2021-10-21","2020-05-22","2021-10-21","2020-10-29","2021-10-21","2020-06-18","2021-01-27","2021-10-21","2021-10-21","2022-02-09","2021-10-21","2020-10-29","2020-10-29","2020-10-29","2022-01-08","2020-09-18","2021-06-15","2021-01-27","2021-01-27","2021-01-27","2021-01-27","2021-01-27","2020-07-30","2020-07-30","2020-07-30","2020-12-09","2021-06-15","2021-06-15","2021-06-15","2021-12-06","2020-06-18","2020-06-18","2020-06-18","2022-02-09","2022-02-09","2022-02-09","2022-02-09","2022-02-09","2022-02-09"],"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":[["","69238183201","LEVOTHYROXIN","TAB 75MCG","90","Select","Select",""],["","68382009405","CARVEDILOL","TAB 12.5MG","60","Select","Select",""],["","70377002811","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","31722093612","OMEGA-3-ACID","CAP 1GM","30","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","50111056003","TRAZODONE","TAB 50MG","30","Select","Select",""],["","00074455290","SYNTHROID","TAB 50MCG","90","Select","Select",""],["","13811071910","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","00093506101","HYDROXYZ","TAB 25MG","30","Select","Select",""],["","57896074206","CALCIUM\/D","TAB 500MG","60","Select","Select",""],["","00536781708","OYSCO","TAB ","60","Select","Select",""],["","68180035302","SERTRALINE","TAB 100MG","30","Select","Select",""],["","29300012401","MELOXICAM","TAB 7.5MG","30","Select","Select",""],["","00904759180","FERROUS","TAB 325MG","60","Select","Select",""],["","65862064163","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","75826011410","PHENAZOPYRID","TAB 100MG","30","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":""}]}]}