{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DASHANEIK COPELAND","gend":1,"add":"68 DALE DR APT G","city":"PORTSMOUTH","state":"VA","zip":"23704-9998","dob":"1994-09-08","age":"","mstatus":"","insh":"2317966*01","cliId":"","pno":"252\/698-1726","cno":"","email":"","ename":"","eno":"","pphy":"NGWA, BENEDICT NP","ppno":"757\/483-1700","pcpadd":"4868 BRIDGE RD STE 300","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23435,"pcpcounty":"","pcpid":"","pcpname":"Lakeview Pediatrics & Family Medicine","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/483-7150","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["NO DATA","M47.816","Z68.41","Z30.42","L03.316","E66.9","Z68.42","R10.33","S09.90XA","M25.571","N93.9","G89.4","G89.29","M53.3","E66.01","M54.5","R07.9","Z79.891","M54.10","M51.26","J01.00","Z79.899","R51.","R10.13","J32.9","J06.9","J02.9","R10.2","Z30.013","S93.401A","F41.1","V87.7XXA","M76.821","R10.31","M48.02","M54.9","Z02.9","Z20.828","Z82.49","Z88.0","Z88.5","R09.81","S43.402A","F41.9","F32.9","M76.71","R42.","R11.2","R40.0","R41.3","Z87.828","M43.6","V89.2XXA","N94.6","M54.16","M54.2","V89.2XXD","S33.5XXA","Z79.1"],"date":["2019-12-18","2020-05-26","2019-07-24","2021-10-14","2021-07-30","2021-07-30","2021-07-30","2021-07-30","2021-10-15","2019-07-16","2019-08-22","2020-04-15","2020-05-26","2020-05-26","2019-10-25","2020-04-15","2021-11-11","2019-11-26","2021-09-24","2021-09-24","2019-06-03","2019-06-03","2019-12-26","2019-09-23","2019-01-30","2019-01-30","2019-01-30","2019-08-22","2020-04-01","2019-01-01","2021-11-11","2019-01-01","2019-07-16","2019-09-19","2019-12-18","2020-02-20","2020-02-20","2020-11-18","2020-11-18","2020-11-18","2020-11-18","2020-11-18","2021-03-22","2021-11-15","2021-11-15","2019-07-16","2019-12-26","2019-12-26","2019-12-26","2019-12-26","2019-12-26","2020-01-13","2020-01-13","2020-04-01","2019-07-24","2020-03-03","2020-01-24","2020-03-03","2021-11-11"],"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":[["","","LORAZEPAM"," LORAZEPAM ","10","Select","Select",""],["","","AMOXICILLIN"," AMOXICILLIN ","20","Select","Select",""],["","","NAPROXEN"," NAPROXEN ","20","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","12","Select","Select",""],["","","BENZONATATE"," BENZONATATE ","30","Select","Select",""],["","","FLUTICASONE"," FLUTICASONE ","16","Select","Select",""],["","","HYDROXYZ"," HYDROXYZ ","30","Select","Select",""],["","","SUDOGEST"," SUDOGEST ","20","Select","Select",""],["","","OXYCOD\/APAP"," OXYCOD\/APAP ","60","Select","Select",""],["","","CETIRIZINE"," CETIRIZINE ","30","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","48","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","15","Select","Select",""],["","","CYCLOBENZAPR"," CYCLOBENZAPR ","60","Select","Select",""],["","","METHOCARBAM"," METHOCARBAM ","15","Select","Select",""],["","","METRONIDAZOL"," METRONIDAZOL ","20","Select","Select",""],["","","OMEPRAZOLE"," OMEPRAZOLE ","30","Select","Select",""],["","","BACLOFEN"," BACLOFEN ","60","Select","Select",""],["","","ONDANSETRON"," ONDANSETRON ","12","Select","Select",""],["","","OXYCODONE"," OXYCODONE ","14","Select","Select",""],["","","AMITRIPTYLIN","TAB 10MG","","Select","Select",""],["","","DICLOFENAC","TAB 75MG DR","","Select","Select",""],["","","TIZANIDINE","TAB 4MG","","Select","Select",""],["","","MELOXICAM","TAB 15MG","","Select","Select",""],["","","LIDOCAINE","PAD 0.05","","Select","Select",""],["","","GABAPENTIN","CAP 100MG","","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":""}]}]}