{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CORTNEY   M METCALF","gend":1,"add":"19149 TOMLIN HILL DR","city":"ZUNI","state":"VA","zip":"23898-9998","dob":"1985-07-13","age":"","mstatus":"","insh":"9472177*01","cliId":"","pno":"757\/509-4648","cno":"","email":"","ename":"","eno":"","pphy":"BRECKE, STEFAN F PA","ppno":"757\/539-0251","pcpadd":"2000 MEADE PARKWAY","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":"23434","pcpcounty":"","pcpid":"","pcpname":"Lakeview Internal Medicine Meade","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/934-9409","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N80.9","F43.12","F32.2","G47.00","R10.11","K76.0","K59.00","Z87.59","M72.2","M67.00","M25.571","G89.29","M25.572","Z68.43","R55.","R60.9","R06.02","R07.9","I51.7","R60.1","Z20.828","Z20.822","N94.9","G43.009","I10.","U07.1","F41.9","F32.9","Z63.0","R42.","R07.89","F32.0","F41.1","Z91.410","Z91.411","D50.9","D51.0","D64.9","Z87.898","R60.0","J32.0","J32.1","J32.2","J32.3","J01.91","J32.9","Z68.42","M54.42","M54.41"],"date":["2020-02-27","2021-11-29","2021-11-29","2021-11-29","2020-02-24","2020-02-24","2020-05-07","2020-05-07","2020-06-08","2020-06-08","2020-06-08","2020-06-08","2020-06-08","2021-06-03","2021-04-26","2020-02-19","2020-03-24","2020-03-11","2020-03-24","2020-03-24","2020-12-14","2021-09-28","2020-02-18","2020-03-23","2020-03-24","2020-12-28","2020-05-19","2020-05-19","2020-05-19","2020-12-21","2021-04-02","2021-04-06","2021-04-06","2021-04-06","2021-04-06","2021-06-03","2021-06-03","2021-06-03","2021-06-03","2020-03-11","2020-05-08","2020-05-08","2020-05-08","2020-05-08","2020-05-08","2020-05-26","2021-05-05","2020-05-21","2020-05-21"],"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":[["","69680011225","CYANOCOBALAM","INJ 1000MCG","2","Select","Select",""],["","00456111030","VIIBRYD","TAB 10MG","30","Select","Select",""],["","16729020001","BUSPIRONE","TAB 5MG","30","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","55513084301","AIMOVIG","INJ 140MG\/ML","1","Select","Select",""],["","00603020922","MAG","TAB 400MG","30","Select","Select",""],["","69097012303","TOPIRAMATE","TAB 50MG","30","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00378180010","LEVOTHYROXIN","TAB 25MCG","30","Select","Select",""],["","00378020810","FUROSEMIDE","TAB 20MG","10","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","10","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","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":""}]}]}