{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JARELL D JOHNSON","gend":0,"add":"3424 CLOVER MDWS APT A","city":"CHESAPEAKE","state":"VA","zip":"23321-9998","dob":"1984-01-20","age":"","mstatus":"","insh":"1759260*01","cliId":"","pno":7576293115,"cno":7576293115,"email":"","ename":"","eno":"","pphy":"TAYLOR, ANDREA NP","ppno":7577381600,"pcpadd":"2613 TAYLOR RD STE 201","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":"23321-9998","pcpcounty":"","pcpid":"","pcpname":"Bon Secours Western Branch Primary Care","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574658616,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K51.919","K92.1","R10.32","R10.33","R11.2","R19.7","Z87.19","G89.29","R10.9","K51.911","K51.90","M06.9","M32.9","Z88.0","Z88.8","Z88.5","Z88.6","Z91.018","R10.84","K52.9","K62.6","Z98.0","K63.3","K91.850","K12.0","Z79.899","L90.5","D64.9","Z90.49","D50.0","Z88.1","R19.5","N52.8","NO DATA","R11.0","K51.811","E83.51","R10.814","R53.83","K51.00","R52.","M13.80","M54.5","M53.3","M17.9","Z91.02","M25.50","M25.561","M25.562","R00.0","K92.2","K51.918","R06.02","K51.819","R10.12","G89.4","Z79.891","Z93.2","R11.10","N52.9","U07.1","E87.6","D50.9","D62.","D72.829","Z83.49","Z82.49","R10.30","K51.80","Z13.31","M17.0","E86.0","R10.812","K51.011","I10.","Z79.52"],"date":["2023-05-08","2023-05-19","2023-05-19","2021-06-29","2023-05-10","2023-05-19","2023-05-19","2023-05-10","2023-03-05","2023-05-19","2023-04-29","2023-05-04","2023-05-04","2023-03-29","2023-03-29","2023-03-29","2023-03-29","2023-03-29","2023-05-08","2022-12-08","2022-12-08","2022-12-08","2022-12-08","2022-12-31","2022-12-08","2023-05-10","2022-12-19","2023-05-03","2023-05-19","2023-01-04","2023-03-29","2023-03-30","2022-11-18","2023-02-01","2023-01-27","2023-03-31","2023-03-31","2023-03-31","2023-04-10","2022-05-09","2021-10-13","2021-06-09","2021-06-09","2021-06-09","2021-06-09","2022-06-20","2022-05-16","2023-02-26","2023-02-26","2022-12-31","2023-01-28","2023-01-30","2023-01-30","2022-12-21","2022-12-26","2023-04-18","2023-04-18","2023-05-04","2022-05-19","2021-07-12","2021-08-30","2023-02-01","2022-12-01","2023-01-28","2023-03-30","2023-01-28","2023-01-28","2021-03-07","2022-09-02","2023-02-17","2023-02-26","2021-01-01","2021-06-22","2021-07-28","2022-06-20","2022-06-20"],"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":[["","65862039010","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","59746017506","PREDNISONE","20 MG","14","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","30","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","8","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","8","Select","Select",""],["","60219175303","SILDENAFIL","TAB 100MG","30","Select","Select",""],["","31722064630","TADALAFIL","20 MG","30","Select","Select",""],["","00574709012","HYDROCORT AC","SUP 25MG","56","Select","Select",""],["","00093031101","LOPERAMIDE","2 MG","30","Select","Select",""],["","42858030101","HYDROMORPHONE HCL","2 MG","30","Select","Select",""],["","65649030103","XIFAXAN","200 MG","168","Select","Select",""],["","65862039010","ONDANSETRON ODT","4 MG","12","Select","Select",""],["","60219175303","SILDENAFIL CITRATE","100 MG","30","Select","Select",""],["","42858010201","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","6","Select","Select",""],["","70710122600","AMITRIPTYLINE HCL","25 MG","30","Select","Select",""],["","00591079501","DICYCLOMINE HCL","20 MG","30","Select","Select",""],["","16571041250","CIPROFLOXACIN HCL","500 MG","14","Select","Select",""],["","50111033401","METRONIDAZOLE","500 MG","14","Select","Select",""],["","53746074501","PROMETHAZINE HCL","12.5 MG","12","Select","Select",""],["","00093216568","NALOXONE HCL","4 MG","2","Select","Select",""],["","00904759080","FEROSUL","325(65) MG","30","Select","Select",""],["","00378041510","DIPHENOXYLATE-ATROPINE","2.5-.025MG","30","Select","Select",""],["","00517231005","VENOFER","200MG\/10ML","20","Select","Select",""],["","53746010901","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","15","Select","Select",""],["","00093005805","TRAMADOL HCL","50 MG","18","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":""}]}]}