{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANNA   M WALKER","gend":1,"add":"16044 STACY LN","city":"WOODFORD","state":"VA","zip":"22580-9998","dob":"1984-04-15","age":"","mstatus":"","insh":"2291655*01","cliId":"","pno":"804\/980-1771","cno":"804\/980-1771","email":"","ename":"","eno":"","pphy":"FUNG, RACQUEL T NP","ppno":"804\/828-9331","pcpadd":"401 N 11TH ST","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23219,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/828-2307","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N39.0","R10.32","R11.10","R10.9","F17.200","J43.9","R30.0","U07.1","Z20.828","N12.","D72.829","N30.01","S93.691A","S63.8X1A","F17.210","S99.911A","D64.9","N13.30","N10.","Z87.440","Z87.448","R11.0","M79.2","Z79.2","Z20.822","Z11.52","R10.12","R63.4","R11.2","K13.79","Z48.814","R00.0","S93.601A","S63.91XA","W19.XXXA","Y92.89","Y93.89","K08.409","R19.7","F90.9","R20.0","F32.1","NO DATA","N32.9","R20.2"],"date":["2022-09-27","2021-10-05","2021-10-05","2021-10-05","2022-04-17","2021-10-05","2021-10-05","2021-03-04","2021-03-06","2020-08-31","2020-08-31","2022-09-20","2021-11-15","2021-11-15","2021-11-15","2021-11-15","2020-08-31","2020-08-31","2020-08-31","2020-09-18","2020-09-18","2020-09-18","2020-09-18","2020-09-18","2021-03-04","2021-03-04","2021-05-04","2021-05-04","2022-04-17","2022-04-17","2022-04-17","2022-04-17","2021-11-15","2021-11-15","2021-11-15","2021-11-15","2021-11-15","2022-04-17","2020-04-21","2020-06-15","2020-06-15","2020-06-15","2020-06-15","2020-06-15","2020-06-15"],"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":[["","71930005552","APAP\/CODEINE","TAB 300-30MG","16","Select","Select",""],["","69097015807","MELOXICAM","TAB 7.5MG","5","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00093226301","AMOXICILLIN","TAB 500MG","21","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","12","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","14","Select","Select",""],["","75826011510","PHENAZOPYRID","TAB 200MG","15","Select","Select",""],["","67877054360","CEFDINIR","CAP 300MG","14","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","28","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","47781030701","NITROFUR","CAP 50MG","40","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","20","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","180","Select","Select",""],["","70710122701","AMITRIPTYLIN","TAB 50MG","30","Select","Select",""],["","42858030101","HYDROMORPHON","TAB 2MG","15","Select","Select",""],["","68180030360","CEFUROXIME","TAB 500MG","20","Select","Select",""],["","49483060350","IBUPROFEN","TAB 600MG","60","Select","Select",""],["","43386035701","HYDROCO\/APAP","TAB 7.5-325","10","Select","Select",""],["","42858010301","OXYCOD\/APAP","TAB 7.5-325","10","Select","Select",""],["","65862053750","LEVOFLOXACIN","TAB 500MG","7","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","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":""}]}]}