{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LOGAN   A LEE","gend":1,"add":"493 SMITH POINT ROAD","city":"REEDVILLE","state":"VA","zip":"22539-9998","dob":"2001-02-02","age":"","mstatus":"","insh":"6881440*01","cliId":"","pno":"804\/925-5630","cno":"","email":"","ename":"","eno":"","pphy":"KEYSER, CANDACE H NP","ppno":"804\/580-7200","pcpadd":"8152 NORTHUMBERLAND HWY","pcpcity":"HEATHSVILLE","pcpstate":"VA","pcpzip":22473,"pcpcounty":"","pcpid":"","pcpname":"CHESAPEAKE HOSPITAL LLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/580-7063","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N91.2","Z20.2","E04.9","Z23.","N76.0","Z68.31","B96.89","Z34.03","Z3A.38","Z3A.39","Z3A.40","O48.0","O77.0","O99.824","O70.1","Z3A.41","Z37.0","F23.","F32.3","J06.9","N89.8","S83.91XA","O99.891","M54.89","Z01.818","Z11.3","F22.","F51.05","F99.","Z68.22","F41.9","Z30.42","Z39.1","Z34.82","Z34.83","Z22.330","NO DATA","F29.","F51.04","F69.","F48.9","Z68.24","N92.1","Z13.29","Z11.59","Z68.26","R51.9","B34.9","R11.0","R19.7","Z20.822","Z20.828","Z01.419","R09.81","Z11.52","N34.1","A49.3","N93.8","R45.1","N93.9","N30.01","Z68.23","Z32.01","R07.9"],"date":["2022-04-27","2022-08-18","2022-04-27","2022-08-18","2022-08-18","2022-08-18","2022-08-18","2021-01-14","2021-01-14","2021-01-14","2021-01-25","2021-02-02","2021-02-01","2021-02-01","2021-02-02","2021-02-02","2021-02-02","2021-05-19","2022-01-27","2022-02-07","2022-08-13","2020-07-30","2021-01-09","2021-01-09","2021-01-14","2021-06-09","2021-06-21","2021-06-21","2021-06-21","2021-06-21","2021-07-23","2022-08-05","2020-12-11","2020-12-11","2020-12-11","2021-01-25","2021-07-29","2021-07-21","2021-07-21","2021-07-21","2021-07-21","2021-07-21","2022-10-10","2021-09-21","2021-09-21","2021-09-21","2021-05-19","2022-07-19","2022-07-19","2022-07-19","2022-07-19","2020-09-17","2020-02-07","2020-12-17","2021-01-14","2022-10-10","2022-10-10","2021-05-17","2021-05-19","2021-05-19","2021-05-19","2021-06-10","2020-06-03","2021-01-09"],"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":[["","27808023302","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","43547033950","RISPERIDONE","TAB 0.25MG","30","Select","Select",""],["","51224012250","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","70954005830","PREDNISONE","PAK 5MG","21","Select","Select",""],["","66993037083","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","42799060501","LOPERAMIDE","CAP 2MG","30","Select","Select",""],["","65162046935","ELURYNG","MIS ","1","Select","Select",""],["","65862014636","SUMATRIPTAN","TAB 25MG","10","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","20","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","67877024601","QUETIAPINE","TAB 200MG","90","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","14","Select","Select",""],["","00178082130","CITRANATAL","MIS 90 DHA","90","Select","Select",""],["","00115180401","HYDROXYZ","CAP 50MG","120","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","5","Select","Select",""],["","80777027315","MODERNA","INJ COVID-19","0","Select","Select",""],["","45802086802","POLYETH","POW 3350 NF","238","Select","Select",""],["","67877043203","ARIPIPRAZOLE","TAB 10MG","30","Select","Select",""],["","63402030430","LATUDA","TAB 40MG","5","Select","Select",""],["","00093532862","JUNEL","TAB 43831","84","Select","Select",""],["","65862001705","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","00225038280","AYR","DRO 0.0065","50","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","65862050220","AMOX\/K","TAB 500-125","10","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","30","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":""}]}]}