{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRUCE   L BOONE","gend":0,"add":"716 HOLLYWOOD AVE","city":"SUFFOLK","state":"VA","zip":"23434-9998","dob":"1971-03-04","age":"","mstatus":"","insh":"2238042*01","cliId":"","pno":"757\/367-0199","cno":"757\/367-0199","email":"","ename":"","eno":"","pphy":"GREER, STEVEN P MD","ppno":"757\/923-1060","pcpadd":"2019 MEADE PARKWAY","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23434,"pcpcounty":"","pcpid":"","pcpname":"Select Specialty Hospital","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","L03.114","G47.33","R60.0","I49.49","R05.","B18.2","L02.414","E11.65","F19.10","R94.31","E83.42","R06.02","F43.21","E11.9","M20.11","Z74.09","M25.561","R07.9","R79.89","K74.69","I10.","Z79.4","F40.10","R06.83","F10.21","F17.200","E66.9"],"date":["2022-09-28","2021-09-16","2020-12-16","2020-11-05","2020-12-15","2021-03-03","2021-04-19","2021-08-10","2021-08-10","2021-08-10","2020-12-01","2020-11-25","2020-11-25","2020-06-08","2020-10-23","2020-04-15","2020-07-10","2020-07-10","2020-10-02","2020-09-09","2020-10-23","2020-10-23","2020-10-23","2020-06-08","2020-01-10","2022-09-28","2022-09-28","2020-08-20"],"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":[["","00469260190","MYRBETRIQ","TAB 25MG","30","Select","Select",""],["","68645048154","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","55111015930","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","57599080300","FREESTY","MIS 2 READER","1","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","15","Select","Select",""],["","43547040211","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","00173071920","FLOVENT","AER 110MCG","12","Select","Select",""],["","00006011254","JANUVIA","TAB 50MG","90","Select","Select",""],["","73070010315","INSULIN","INJ FLEXPEN","15","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","00093216568","NALOXONE","SPR 4MG","2","Select","Select",""],["","08290320122","BD  PEN NEEDL","MIS 32GX4MM","100","Select","Select",""],["","31722071030","SILDENAFIL","TAB 50MG","30","Select","Select",""],["","00093083205","CLONAZEPAM","TAB 0.5MG","14","Select","Select",""],["","43598058230","BUPREN\/NALOX","MIS 8-2MG","30","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","2","Select","Select",""],["","60258017101","MAG","TAB 400MG","30","Select","Select",""],["","72626270101","SOFOS\/VELPAT","TAB 400-100","28","Select","Select",""],["","67877022310","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","68645055154","LISINOPRIL","TAB 5MG","90","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","40","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","60","Select","Select",""],["","51672129801","KETOCONAZOLE","CRE 0.02","90","Select","Select",""],["","68645051554","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","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":""}]}]}