{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAMIKA SPENCER","gend":1,"add":"7400 RIVER RD APT B","city":"NEWPORT NEWS","state":"VA","zip":"23607-9998","dob":"1983-06-06","age":"","mstatus":"","insh":"1713045*01","cliId":"","pno":7576979866,"cno":7576979866,"email":"","ename":"","eno":"","pphy":"TORRY, CHE DO","ppno":7573106413,"pcpadd":"1030 LOFTIS BLVD STE 201,","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":"23606-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7573106404,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.16","M75.121","M25.511","G89.29","S39.012A","M47.816","B20.","Z79.899","E66.01","Z68.41","Z32.02","Z23.","V58.89","M25.552","NO DATA","H18.603","H40.053","H40.043","S39.011A","G89.4","Z51.81","M65.811","S46.211A","M25.811","U07.1","I10.","Z88.0","Z88.5","R05.9","M75.111","M75.41","Z02.9","R50.9","Z20.822","M46.1","R73.09","F32.9","Z68.42","Z13.89","S43.421A","R43.0","R43.2","Z86.16","M47.817","Z79.891","Z21.","Z72.0","Z59.9","R07.89","E78.5","F41.9"],"date":["2023-09-12","2023-03-28","2023-06-30","2023-06-15","2022-09-30","2023-08-21","2022-10-10","2023-08-30","2021-06-02","2021-06-02","2021-09-12","2022-09-14","2022-01-31","2022-01-31","2023-07-17","2022-02-28","2022-02-28","2021-08-16","2022-01-26","2023-04-21","2023-04-21","2023-03-22","2023-03-22","2023-03-22","2021-10-04","2021-10-04","2021-10-04","2021-10-04","2021-11-04","2023-03-22","2023-03-22","2023-04-21","2021-10-04","2021-10-04","2022-04-21","2022-10-10","2022-10-10","2022-10-10","2022-10-10","2021-07-23","2021-10-18","2021-10-18","2021-10-18","2023-09-12","2022-01-04","2023-08-30","2022-09-14","2022-09-14","2022-10-27","2022-10-27","2023-08-21"],"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":[]},{"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":[["","55111017915","TIZANIDINE","TAB 2MG","30","Select","Select",""],["","61958210101","ODEFSEY","200-25-25","30","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","30","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","30","Select","Select",""],["","70069023101","BRIMONIDINE","SOL 0.2% OP","15","Select","Select",""],["","60758011905","PREDNISOLONE","SUS 1% OP","5","Select","Select",""],["","29300041301","CYCLOBENZAPR","TAB 5MG","60","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","68382005105","MELOXICAM","15 MG","30","Select","Select",""],["","00406051201","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","28","Select","Select",""],["","65862018830","ONDANSETRON HCL","8 MG","30","Select","Select",""],["","65162062710","TRAMADOL HCL","50 MG","28","Select","Select",""],["","29300041301","CYCLOBENZAPRINE HCL","5 MG","60","Select","Select",""],["","61958210101","ODEFSEY TAB","","30","Select","Select",""],["","55111017915","TIZANIDINE TAB","2MG","30","Select","Select",""],["","70010077001","METHOCARBAM TAB","750MG","30","Select","Select",""],["","16571020210","DICLOFENAC TAB","50MG DR","30","Select","Select",""],["","60758011905","PREDNISOLONE SUS","1% OP","5","Select","Select",""],["","70069023101","BRIMONIDINE SOL","0.2% OP","5","Select","Select",""],["","42806040021","METHYLPRED TAB","4MG","21","Select","Select",""],["","68382005101","MELOXICAM TAB","15MG","30","Select","Select",""],["","29300041301","CYCLOBENZAPR TAB","5MG","60","Select","Select",""],["","52817031910","BACLOFEN","5 MG","90","Select","Select",""],["","69315090405","LORAZEPAM","0.5 MG","2","Select","Select",""],["","50228018001","GABAPENTIN","300 MG","90","Select","Select",""],["","65162046650","IBUPROFEN","800 MG","90","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":""}]}]}