{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIRSTEN   N GREENE CARTER","gend":1,"add":"317 CHARLES ST","city":"NEWPORT NEWS","state":"VA","zip":"23608-9998","dob":"1992-06-17","age":"","mstatus":"","insh":"2205128*01","cliId":"","pno":"757\/705-0792","cno":"","email":"","ename":"","eno":"","pphy":"ELLIOTT, JOY DO","ppno":"757\/594-3800","pcpadd":"10510 JEFFERSON AVENUE STE A","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23601,"pcpcounty":"","pcpid":"","pcpname":"Riverside Brentwood Medical Center","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/594-3818","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","Z01.419","Z32.02","Z11.3","F41.9","F11.99","Z30.09","Z30.016","H69.83","G56.01","K13.0","G40.909","M54.5","G89.29","Z91.19","F19.90","M43.17","M54.31","J45.20","Z79.891","T78.40XA","Z87.891","M54.16","F33.1","G47.00","R53.83","G47.9","E66.9","Z68.33","J00.","M54.41","O36.5930","Z3A.30","O35.9XX0","O99.320","Z3A.32","Z3A.33","Z3A.35","O80.","Z37.0","Z3A.00","F43.10","O99.824","O99.52","O71.82","O75.89","E86.0","O99.344","O99.354","O36.8330","O90.89","E87.6","E83.42","O99.324","F19.10","R20.2","Z3A.34","Z39.1","L70.0","Z3A.36","O99.323","O21.2","Z3A.38","Z34.82","O99.352","A49.02","Z88.5","R21."],"date":["2020-10-15","2020-02-25","2020-02-25","2020-02-25","2020-10-23","2020-08-27","2020-02-25","2020-02-25","2020-08-27","2020-03-12","2020-08-27","2020-10-23","2020-02-26","2020-02-26","2020-02-26","2020-02-26","2020-03-26","2020-03-26","2020-10-23","2020-10-23","2020-03-12","2020-08-27","2020-02-07","2021-03-19","2020-03-27","2020-03-27","2020-03-27","2020-03-27","2020-03-27","2020-01-14","2020-02-11","2019-08-20","2019-08-06","2019-09-17","2019-09-17","2019-08-20","2019-08-30","2019-09-13","2019-09-28","2019-09-29","2019-09-28","2019-11-27","2019-09-27","2019-09-27","2019-09-27","2019-09-27","2019-09-27","2019-09-27","2019-09-27","2019-09-27","2019-09-27","2019-09-27","2019-09-27","2019-09-27","2019-09-27","2019-11-13","2019-09-03","2019-10-01","2019-07-09","2019-09-17","2019-09-29","2019-09-29","2019-09-29","2019-10-04","2019-07-09","2022-05-21","2022-05-21","2022-05-21"],"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":[["","67253090150","ALPRAZOLAM","TAB 0.5MG","90","Select","Select",""],["","00536106210","STOOL","CAP 100MG","60","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","","BENZONATATE","CAP 100MG","","Select","Select",""],["","51672408104","CLINDAMYCIN","SOL 0.01","60","Select","Select",""],["","00093083205","CLONAZEPAM","TAB 0.5MG","120","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00536406301","CL","TAB 28-0.8MG","30","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","","FETZIMA","CAP 20MG","","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","","FERROUS","TAB 325MG","","Select","Select",""],["","","HYDROCO\/APAP","TAB 7.5-325","","Select","Select",""],["","","XULANE","DIS 150-35","","Select","Select",""],["","","DULOXETINE","CAP 30MG","","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","","TRAZODONE","TAB 50MG","","Select","Select",""],["","00093742698","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","","BUSPIRONE","TAB 10MG","","Select","Select",""],["","","BUDES\/FORMOT","AER 80-4.5","","Select","Select",""],["","","SYMBICORT","AER 160-4.5","","Select","Select",""],["","59746017710","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","60","Select","Select",""],["","31722053705","LEVETIRACETA","TAB 500MG","60","Select","Select",""],["","51862088603","ERRIN","TAB 0.35MG","28","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","61442010210","DICLOFENAC","TAB 50MG DR","14","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":""}]}]}