{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KATHERINE   A WILSON","gend":1,"add":"104 OLDHAM WAY","city":"NEWPORT NEWS","state":"VA","zip":"23608-9998","dob":"1991-12-27","age":"","mstatus":"","insh":"2236954*01","cliId":"","pno":"757\/660-2183","cno":"757\/660-2183","email":"","ename":"","eno":"","pphy":"HIOTELLIS, APOSTOLOS MD","ppno":"757\/659-6287","pcpadd":"860 OMNI BLVD SUITE 112","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23606,"pcpcounty":"","pcpid":"","pcpname":"TPMG CITY CENTER FAMILY MEDICINE","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/586-5284","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N39.0","T81.49XA","E66.01","Z68.41","T78.40XA","Z23.","E88.81","N17.9","E87.6","D50.9","E28.2","Z12.4","N92.6","N83.201","D27.0","T81.40XA","Z02.0","H00.011","T81.42XD","K59.00","H81.13","Z68.42","Z90.721","Z01.419","A41.9","T81.41XA","T81.89XA","S39.81XA","N90.89","R10.32","Z30.09","R19.00","T88.59XA","N17.0","L03.311","T81.44XA","T39.315A","K76.0","M54.42","M54.41","E66.9","E87.8","D62."],"date":["2020-01-29","2020-08-16","2020-09-22","2020-08-16","2020-08-16","2020-09-09","2022-09-18","2020-09-03","2020-08-19","2020-09-22","2021-10-27","2020-07-08","2020-07-08","2020-07-08","2020-08-06","2020-08-16","2020-12-12","2020-11-20","2020-09-22","2020-09-22","2020-09-22","2020-09-22","2020-09-22","2021-10-27","2020-08-14","2020-08-17","2020-08-21","2020-08-21","2022-02-24","2022-10-03","2022-10-03","2020-09-03","2020-08-06","2020-08-14","2020-08-14","2020-08-14","2020-08-14","2020-08-14","2020-08-14","2020-08-14","2020-08-14","2020-08-14","2020-09-03"],"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":[["","00527150437","AMPHET\/DEXTR","TAB 15MG","60","Select","Select",""],["","51672126302","NYSTAT\/TRIAM","CRE ","30","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","65162044110","MECLIZINE","TAB 12.5MG","60","Select","Select",""],["","57844011501","ADDERALL","TAB 15MG","60","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","68382075810","METFORMIN","TAB 500MG","60","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","75826011510","PHENAZOPYRID","TAB 200MG","6","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","47781019601","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","30","Select","Select",""],["","00536100901","FERROUS","TAB 325MG","90","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN 5MG\/GM","4","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":""}]}]}