{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MICHELLE COLE","gend":1,"add":"1251 21ST ST UNIT A","city":"NEWPORT NEWS","state":"VA","zip":23607,"dob":"1972-06-22","age":"","mstatus":"","insh":"2296552*01","cliId":"","pno":"803\/297-0281","cno":"803\/297-0281","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"757\/930-0091","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23607,"pcpcounty":"","pcpid":"","pcpname":"Commonwealth Family Practice","plan":"OHP","program":"Medicaid","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/269-4406","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.33","J42.","M25.561","G89.29","M17.11","Z23.","M65.312","M79.645","R07.9","I10.","R06.02","Z99.89","R06.83","H35.033","R51.9","H52.4","Z63.8","I25.110","E66.01","Z68.42","R42.","R03.0","M94.0","M70.62","R05.8","Z86.16","Z87.891","I25.119","NO DATA","M25.562","I25.10","E78.5","E87.6","K21.9","J45.909","Z86.73","Z79.899","Z01.419","R51.","Z12.11","M17.0","R20.2","F51.12","E66.9","Z68.43","J30.1","R11.10","R74.8","R19.7","M54.9","J06.9","Z20.822","Z91.048","M51.26","M51.36","G43.909","Z11.1","N95.1","R07.89","D3A.026","K57.30","Z20.828","M25.532","Z86.010","Z86.69","Z88.8","Z91.018","Z11.59","R26.89","N93.9","R94.31","Z82.49","R11.2","U07.1","R53.83","M54.5","G45.9","R29.818","M25.569","R20.0","R05.9","H53.9","E78.00","M65.4","K62.1","H04.123","R07.2"],"date":["2022-01-25","2022-01-17","2022-02-22","2022-07-18","2021-12-10","2022-07-18","2022-09-04","2022-09-04","2022-06-02","2022-04-19","2022-01-25","2020-06-19","2021-03-16","2021-11-11","2020-11-05","2021-11-11","2021-11-17","2021-07-14","2022-07-18","2022-07-18","2021-10-22","2021-10-22","2022-01-17","2022-01-17","2022-01-17","2022-01-17","2022-01-25","2022-01-17","2022-07-18","2022-02-22","2022-04-19","2022-01-25","2022-01-25","2022-01-25","2022-01-25","2022-04-19","2022-04-19","2020-07-20","2020-07-20","2020-09-02","2021-08-16","2021-03-20","2021-03-16","2022-04-19","2021-10-28","2021-03-16","2021-08-01","2021-08-16","2021-08-01","2021-12-22","2022-01-31","2022-01-31","2022-01-31","2022-02-02","2022-02-02","2022-07-18","2022-07-18","2022-07-18","2022-07-18","2020-12-02","2020-12-02","2020-09-28","2020-11-05","2020-12-02","2022-04-19","2022-06-02","2022-04-19","2020-09-28","2020-10-08","2021-04-18","2021-07-15","2021-07-15","2021-10-22","2022-01-11","2022-01-06","2021-08-16","2021-03-20","2021-03-21","2021-11-12","2021-11-12","2022-01-06","2020-06-19","2020-06-19","2020-09-24","2020-12-02","2021-11-11","2022-06-02"],"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":[["","68180096301","ALBUTEROL","AER HFA","17","Select","Select",""],["","65162019011","NAPROXEN","TAB 500MG","60","Select","Select",""],["","13668011005","DULOXETINE","CAP 30MG","60","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","00591060501","LABETALOL","TAB 100MG","180","Select","Select",""],["","68645051054","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","60505003901","ETODOLAC","CAP 200MG","20","Select","Select",""],["","00121077516","GG\/CODEINE","SOL 100-10\/5","120","Select","Select",""],["","51224001060","BENZONATATE","CAP 100MG","30","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","21","Select","Select",""],["","68382009716","PAROXETINE","TAB 10MG","30","Select","Select",""],["","58657050016","CODEINE\/GG","SOL 10-100\/5","120","Select","Select",""],["","00904698640","MUCUS","TAB 600MG ER","60","Select","Select",""],["","29300041519","CYCLOBENZAPR","TAB 10MG","20","Select","Select",""],["","00591350804","CLONIDINE","DIS 0.1\/24HR","4","Select","Select",""],["","45802021002","NITROGLYCRN","SPR 0.4MG","12","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","00597003134","CATAPRES-TTS","DIS 0.1\/24HR","4","Select","Select",""],["","00832105415","BACLOFEN","TAB 10MG","60","Select","Select",""],["","29300011616","TOPIRAMATE","TAB 50MG","35","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","10702002901","PHENTERMINE","CAP 37.5MG","30","Select","Select",""],["","00832532410","POT  CL MICRO","TAB 10MEQ ER","60","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","08290320109","BD  PEN NEEDL","MIS 31GX8MM","100","Select","Select",""],["","00169280015","SAXENDA","INJ 18MG\/3ML","15","Select","Select",""],["","68382004101","PROMETHAZINE","TAB 25MG","15","Select","Select",""],["","68645056854","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","30","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","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":""}]}]}