{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"STEVEN CAMPBELL","gend":0,"add":"9832 COURTHOUSE RD","city":"SPOTSYLVANIA","state":"VA","zip":"22553-9998","dob":"1970-10-13","age":"","mstatus":"","insh":"2197232*01","cliId":"","pno":"540\/429-1218","cno":"","email":"","ename":"","eno":"","pphy":"KAHN, ENAMUL MD","ppno":"540\/659-0550","pcpadd":"SUITE 101 237 GARRISONVILLE RD","pcpcity":"STAFFORD","pcpstate":"VA","pcpzip":22554,"pcpcounty":"","pcpid":"","pcpname":"NS FAMILY MEDICAL CENTER INC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/720-2386","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","L25.9","L40.9","R21.","I10.","L40.52","B19.20","L29.9","F41.9","S92.515A","L40.50","Z79.899","Z86.19","R79.89","F17.210","F11.21","M54.5","M53.86","M25.521","R42.","NO DATA","M13.0","M67.813","M25.511","M19.021","R06.00","M70.21","Z00.00","Z12.11","J06.9","J02.9","J01.90","S92.402A","I25.84","E78.5","Z72.0","M77.9","G89.4","I49.8","R94.5","M47.816","M51.37","E55.9","L23.7","G89.29","M25.512","Z20.828","Z96.643","Z11.1","M54.16","K21.9","M54.2"],"date":["2020-07-02","2019-09-28","2022-10-19","2022-10-19","2022-05-20","2021-06-21","2020-06-22","2021-12-17","2022-05-20","2020-09-24","2022-08-18","2022-08-18","2022-08-18","2021-07-14","2020-12-14","2021-09-28","2020-05-20","2019-07-31","2022-03-21","2021-03-26","2021-11-18","2022-03-23","2021-09-18","2022-03-23","2021-11-18","2021-03-26","2019-07-16","2020-01-09","2020-06-22","2022-01-25","2020-03-06","2020-03-06","2020-10-01","2021-03-26","2021-03-26","2021-03-26","2021-10-05","2019-08-20","2019-09-15","2020-06-22","2020-05-20","2020-05-20","2020-06-22","2022-05-20","2022-03-23","2022-03-23","2022-01-25","2022-08-18","2022-08-18","2022-03-21","2022-10-19","2022-10-19"],"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":[["","50474071079","CIMZIA","KIT 200MG\/ML","3","Select","Select",""],["","","ALPRAZOLAM"," ALPRAZOLAM ","90","Select","Select",""],["","","CARVEDILOL"," CARVEDILOL ","60","Select","Select",""],["","","LISINOPRIL"," LISINOPRIL ","30","Select","Select",""],["","00078063941","COSENTYX","INJ 300DOSE","2","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","30","Select","Select",""],["","","GABAPENTIN"," GABAPENTIN ","90","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","90","Select","Select",""],["","60505257908","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","00378363705","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","42806071505","BENZONATATE","CAP 200MG","30","Select","Select",""],["","","VITAMIN","CAP 50000UNT","","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","2","Select","Select",""],["","50742022515","TIZANIDINE","CAP 4MG","30","Select","Select",""],["","","TRAZODONE","TAB 100MG","","Select","Select",""],["","","BUPREN\/NALOX","MIS 12-3MG","","Select","Select",""],["","61442010301","DICLOFENAC","TAB 75MG DR","30","Select","Select",""],["","51672201802","HYDROCORT","OIN 0.01","28","Select","Select",""],["","","SUBOXONE","MIS 12-3MG","","Select","Select",""],["","","SHINGRIX","INJ 50\/0.5ML","","Select","Select",""],["","65862001401","AMOXICILLIN","TAB 500MG","21","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","00378064210","PREDNISONE","TAB 20MG","10","Select","Select",""],["","00406048401","APAP\/CODEINE","TAB 300-30MG","30","Select","Select",""],["","00074262528","MAVYRET","TAB 100-40MG","84","Select","Select",""],["","43386009662","CLOBETASOL","OIN 0.0005","60","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","51672128202","TRIAMCINOLON","CRE 0.001","60","Select","Select",""],["","","SULFASALAZIN","TAB 500MG","","Select","Select",""],["","","OTEZLA","TAB 30MG","","Select","Select",""],["","","FLUZONE","INJ 2020-21","","Select","Select",""],["","","LEFLUNOMIDE","TAB 10MG","","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":""}]}]}