{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIA  I BROWN","gend":1,"add":"1509 RING RD APT 215","city":"CHESAPEAKE","state":"VA","zip":23320,"dob":"1986-10-01","age":"","mstatus":"","insh":"8447551*01","cliId":"","pno":"757\/300-7754","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"757\/625-3777","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23320,"pcpcounty":"","pcpid":"","pcpname":"MICHAEL L TUCKER MD FAMILY PRACTICE","plan":"OHP","program":"Medicaid","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/625-7411","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R29.90","F14.10","I67.841","I63.321","E11.9","Z79.4","H17.822","H40.1131","I63.511","R29.810","R47.81","R29.702","G31.9","I69.398","G93.89","F12.90","E11.65","E78.5","R47.02","Z83.3","Z82.3","Z82.0","Z91.14","I63.9","Z01.89","E10.65","E78.2","I67.2","Z01.411","L29.2","N89.8","G50.1","R20.0","R20.9","S22.42XA","S27.331A","S27.2XXA","S42.002A","J94.8","J94.2","R52.","N39.0","V54.19","R07.1","R79.89","J18.9","M54.6","S36.029A","M84.375A","M79.672","S27.1XXA","V87.7XXA","U07.1","V58.69","Z87.891","Z88.0","R07.9","H20.9","H10.89","H16.002","H18.823","N12.","Z88.3","R10.9","B96.89","N76.0","Z86.39","N30.01","E87.1","E87.5","Z86.73","R10.32"],"date":["2020-03-23","2020-03-23","2020-03-23","2020-03-23","2022-09-12","2020-03-20","2020-02-21","2020-02-21","2020-03-20","2020-03-20","2020-03-20","2020-03-20","2020-03-20","2020-03-20","2020-03-20","2020-03-20","2021-11-21","2020-03-20","2020-03-20","2020-03-20","2020-03-20","2020-03-20","2021-11-21","2020-03-22","2020-03-21","2020-03-22","2020-03-22","2020-03-22","2020-07-06","2020-07-06","2020-07-06","2019-12-12","2019-12-12","2019-12-12","2019-05-19","2019-05-03","2019-05-01","2019-05-03","2019-05-03","2019-05-03","2019-05-19","2019-05-19","2019-08-06","2019-05-15","2019-05-15","2019-05-06","2019-05-18","2019-05-03","2019-09-27","2019-09-27","2019-05-03","2019-05-02","2021-01-05","2021-01-05","2022-09-12","2022-09-12","2021-01-05","2020-11-02","2020-11-02","2020-10-30","2020-10-30","2022-09-12","2022-09-12","2021-12-19","2021-11-21","2021-11-21","2021-11-21","2022-09-12","2022-09-12","2022-09-12","2022-09-12","2022-09-12"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","65162068210","PHENAZOPYRID","TAB 200MG","6","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","10","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","17478007035","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","00169183711","NOVOLIN","INJ 70\/30","10","Select","Select",""],["","73070020011","INSULIN","INJ 70\/30","10","Select","Select",""],["","65862001905","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","","CLOPIDOGREL","TAB 75MG","","Select","Select",""],["","","NYSTATIN","CRE 100000","","Select","Select",""],["","","TRIAMCINOLON","CRE 0.001","","Select","Select",""],["","","NYSTAT\/TRIAM","CRE ","","Select","Select",""],["","","VALACYCLOVIR","TAB 500MG","","Select","Select",""],["","","MOXIFLOXACIN","SOL HCL 0.5%","","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","15","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","14","Select","Select",""],["","65862020005","GABAPENTIN","CAP 400MG","90","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","12","Select","Select",""],["","00904645780","DOK","CAP 100MG","30","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","68382031910","TRAMADOL","TAB 50MG","20","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","00002803101","GLUCAGON","KIT 1MG","2","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}