{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MICHAEL J DAVIS","gend":0,"add":"7704 ENFIELD AVE APT C7","city":"NORFOLK","state":"VA","zip":"23505-9998","dob":"1983-06-08","age":"","mstatus":"","insh":"1672892*01","cliId":"","pno":7579492328,"cno":7579492328,"email":"","ename":"","eno":"","pphy":"NEWBY, JAMES E MD","ppno":7576276892,"pcpadd":"STE 220 930 MAJESTIC AVE,","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23504-9998","pcpcounty":"","pcpid":"","pcpname":"Primary Care Specialists","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576275809,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.33","J45.40","R06.02","R06.2","NO DATA","I10.","G47.30","Z87.891","Z86.73","Z79.899","Z79.82","Z82.49","Z80.1","E11.9","E13.10","I60.9","Z68.36","Z23.","I61.9","Z68.31","E86.0","Z68.30","Z68.33","G47.37","R06.3","Z98.890","E11.65","Z79.4","E78.1","Z71.89","Z68.32","Z20.822","Z86.79","Z68.34"],"date":["2023-05-27","2021-07-01","2021-06-07","2021-04-09","2022-05-02","2023-03-09","2022-05-02","2023-03-09","2022-05-02","2022-05-02","2022-05-02","2022-05-02","2022-05-02","2023-03-09","2022-05-04","2021-06-07","2021-06-07","2021-07-06","2023-03-09","2022-06-06","2022-05-02","2022-05-02","2023-03-09","2021-05-04","2021-05-04","2023-01-26","2022-05-19","2022-05-19","2022-05-19","2022-05-19","2022-05-19","2022-01-14","2023-01-26","2021-03-08"],"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":[["","50742062101","NIFEDIPINE","TAB 60MG ER","30","Select","Select",""],["","29300019019","LOSARTAN\/HCT","TAB 50-12.5","30","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA","100","Select","Select",""],["","08290320547","BD PEN NEEDL","MIS 32GX4MM","200","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","100","Select","Select",""],["","00378718505","METFORMIN","TAB 500MG","60","Select","Select",""],["","31722052101","HYDRALAZINE","TAB 50MG","30","Select","Select",""],["","11877001140","BINAXNOW COV","KIT HOME TES","4","Select","Select",""],["","00002771559","BASAGLAR","INJ 100UNIT","6","Select","Select",""],["","00486112501","K-PHOS","TAB NEUTRAL","2","Select","Select",""],["","00002879959","HUMALOG KWIK","INJ 100\/ML","3","Select","Select",""],["","55111012105","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","00002822259","INSULIN LISP","INJ 100\/ML","3","Select","Select",""],["","50742062101","NIFEDIPINE ER","60 MG","30","Select","Select",""],["","43598083005","ATORVASTATIN CALCIUM","10 MG","6","Select","Select",""],["","31722052101","HYDRALAZINE HCL","50 MG","30","Select","Select",""],["","00378718505","METFORMIN HCL","500 MG","60","Select","Select",""],["","65862046890","LOSARTAN-HYDROCHLOROTHIAZIDE","50-12.5 MG","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":""}]}]}