{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ZACHARY CONNER","gend":0,"add":"2040 DUNBARTON DR APT 1","city":"VIRGINIA BEACH","state":"VA","zip":"23454-9998","dob":"2003-08-27","age":"","mstatus":"","insh":"8939985*01","cliId":"","pno":"757\/675-2986","cno":"","email":"","ename":"","eno":"","pphy":"GARNER, KELSEY J PA","ppno":"757\/842-4100","pcpadd":"725 VOLVO PKWY","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23320,"pcpcounty":"","pcpid":"","pcpname":"Nowcare Volvo","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/410-3562","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25.562","M79.641","V62.84","Z20.828","F90.2","F32.9","T14.91XA","F91.2","F19.10","Z00.8","V89.2XXA","Y92.810","Y93.89","M54.5","Z65.3","S80.02XA","S00.33XA","V00.131A","F32.2","F91.3","F12.10","F13.20","F33.9","Z23.","J02.9","J35.1","F81.9","Z00.129","F10.10","S63.8X1A","F31.62","F12.150","Z72.0","T07.XXXA","V29.9XXA","F90.9","Z87.891","J01.00","F32.1","NO DATA","R21.","R20.2","L25.9","S05.90XA","S02.2XXA","S09.90XA"],"date":["2020-10-05","2021-10-20","2021-08-15","2020-11-23","2020-12-03","2021-08-15","2020-12-03","2021-02-01","2021-08-15","2021-08-15","2021-08-15","2021-08-15","2021-08-15","2021-08-15","2021-08-15","2020-10-05","2020-10-05","2020-10-05","2020-11-28","2020-11-23","2020-11-23","2020-11-23","2020-11-24","2021-09-23","2021-06-03","2021-06-03","2019-05-06","2019-05-06","2019-08-15","2019-08-20","2019-10-07","2019-10-07","2019-10-07","2019-04-02","2019-04-02","2019-08-14","2019-08-14","2019-02-21","2019-09-17","2022-03-30","2022-03-11","2022-01-31","2022-07-26","2022-07-26","2022-08-29","2022-08-29"],"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":[["","70954006020","PREDNISONE","TAB 20MG","18","Select","Select",""],["","23155050105","HYDROXYZ","TAB 25MG","30","Select","Select",""],["","67877025145","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","20","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","51672131200","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","","ADDERALL","CAP 20MG","","Select","Select",""],["","","AMPHET\/DEXTR","CAP 20MG ER","","Select","Select",""],["","65862019301","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","65862007101","AMOXICILLIN","SUS 400\/5ML","200","Select","Select",""],["","63304092501","GUANFACINE","TAB 2MG ER","30","Select","Select",""],["","65862049001","QUETIAPINE","TAB 50MG","30","Select","Select",""],["","00093867574","AMOX\/K","SUS 600\/5ML","200","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":""}]}]}