{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HUNTER  J FLEEMAN","gend":0,"add":"85 CARDINAL ROAD","city":"CARDINAL","state":"VA","zip":"23025-9998","dob":"2002-10-10","age":"","mstatus":"","insh":"1726515*01","cliId":"","pno":7577151494,"cno":7577151494,"email":"","ename":"","eno":"","pphy":"RHODES, SHARON NP","ppno":7579631488,"pcpadd":"4421 VIRGINIA BEACH BLVD STE 112","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23462-9998","pcpcounty":"","pcpid":"","pcpname":"COASTAL ENDOCRINOLOGY","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7577636350,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R41.82","E10.65","E10.9","F84.0","F90.9","F80.9","G96.9","H40.053","K52.9","Z20.828","F80.89","H93.292","H91.22","H61.23","H60.392","H92.12","F43.20","F90.0","F41.9","Z20.822","F33.0","NO DATA","E87.6","E83.30","N17.9","E83.42","R33.9","E86.0","H60.332","H69.82"],"date":["2021-04-19","2023-03-05","2023-03-08","2022-07-21","2022-01-14","2022-01-14","2022-07-21","2022-11-08","2021-04-14","2021-04-14","2021-06-04","2022-01-10","2022-01-07","2022-01-07","2022-01-17","2022-01-10","2021-09-20","2021-09-30","2021-01-19","2021-01-19","2021-04-09","2021-04-17","2021-04-17","2021-04-17","2021-04-17","2021-04-17","2021-11-05","2021-04-15","2021-09-27","2022-01-17"],"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":[["","52817080030","CLOTRIMAZOLE","SOL 0.01","30","Select","Select",""],["","65862019201","FLUOXETINE","CAP 10MG","90","Select","Select",""],["","00078094640","TRAVATAN Z","0.004 %","2.5","Select","Select",""],["","42571013027","TRAVOPROST","0.004 %","2.5","Select","Select",""],["","50458058601","CONCERTA","TAB 36MG","90","Select","Select",""],["","56151146001","TRUE METRIX","TES GLUCOSE","50","Select","Select",""],["","08627001601","DEXCOM G6","MIS TRANSMIT","1","Select","Select",""],["","00002614511","BAQSIMI ONE","POW 3MG\/DOSE","1","Select","Select",""],["","57513000634","PEN NEEDLES","MIS 32GX5MM","100","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","50","Select","Select",""],["","86227012105","SURE COMFORT","MIS 31GX3\/16","100","Select","Select",""],["","00002879959","HUMALOG KWIK","INJ 100\/ML","15","Select","Select",""],["","00002773701","INSULIN LISP","INJ 100\/ML","20","Select","Select",""],["","31722095401","METHYLPHENID","TAB 36MG ER","30","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","100","Select","Select",""],["","65862019201","FLUOXETINE HCL","10 MG","90","Select","Select",""],["","00002773701","INSULIN LISPRO","100\/ML","20","Select","Select",""],["","00002614527","BAQSIMI","3 MG","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":[]}},{"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":""}]}]}