{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAVID TURNER","gend":0,"add":"3 LAUREL DR","city":"HAMPTON","state":"VA","zip":"23669-9998","dob":"1963-04-07","age":"","mstatus":"","insh":"2231800*01","cliId":"","pno":"757\/902-3126","cno":"757\/902-3126","email":"","ename":"","eno":"","pphy":"HOYT JR, P ARTHUR MD","ppno":"757\/223-4992","pcpadd":"2205 EXECUTIVE DRIVE SUITE A","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":23666,"pcpcounty":"","pcpid":"","pcpname":"HAMPTON FAMILY MEDICINE","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/223-5350","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M79.671","M25.674","G58.9","G90.521","I82.441","NO DATA","L53.9","Z86.718","L03.115","R26.89","Z09.","I82.409","I82.5Y1","G62.9","M21.371","L85.3","R22.41","R22.42","R20.2","R60.9","M79.2","M62.82","Z72.0","Z72.89","Z86.79","I00.","Z87.39","J43.9","E78.5","Z68.34"],"date":["2020-03-18","2020-03-18","2020-03-18","2020-03-18","2020-02-11","2020-02-11","2020-02-11","2020-12-21","2020-07-17","2020-01-10","2020-07-17","2020-07-17","2020-02-11","2020-04-23","2020-04-23","2020-04-23","2020-12-09","2020-11-09","2020-03-16","2020-12-21","2020-12-21","2020-12-21","2020-12-21","2020-12-21","2020-12-21","2020-12-21","2020-12-21","2020-12-21","2020-12-21","2020-12-21"],"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":[]},{"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":[["","50228018005","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","68382085701","TRIAMT\/HCTZ","TAB 75-50MG","30","Select","Select",""],["","59267100003","PFIZER","INJ COVID-19","0","Select","Select",""],["","00003089321","ELIQUIS","TAB 2.5MG","20","Select","Select",""],["","69238131209","PREGABALIN","CAP 75MG","60","Select","Select",""],["","10702002301","OXYCODONE","CAP 5MG","12","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","15","Select","Select",""],["","47781035703","BUPREN\/NALOX","MIS 8-2MG","15","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","12","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":""}]}]}