{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDSEY  E BROWN","gend":1,"add":"1637 WICOMICO LN","city":"VIRGINIA BEACH","state":"VA","zip":"23464-9998","dob":"2003-04-06","age":"","mstatus":"","insh":"1764362*01","cliId":"","pno":7574501897,"cno":7574501897,"email":"","ename":"","eno":"","pphy":"KHAN, GHAZALA Y MD","ppno":7574957420,"pcpadd":"STE 114 4221 PLEASANT VALLEY,","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23464-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574953917,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N39.0","N30.01","M79.644","L60.8","Z89.021","Z46.89","T87.89","S68.112S","R20.8","L60.0","Z94.5","R51.9","T87.31","NO DATA","R10.30","N89.8","N93.9","L90.5","M25.641","R60.0","R20.3","M79.89","Z01.812","Z20.822","Z01.419","Z20.2","M20.091","Z91.040","V58.89","S96.912A","M25.572","G89.11","Z30.09","L90.8","G43.909","J06.9","R06.02","R00.0","R00.2","R11.2","Z79.899","L70.8"],"date":["2023-01-04","2022-11-06","2023-05-09","2022-01-25","2022-08-08","2022-01-13","2023-07-12","2023-07-12","2023-05-09","2021-05-25","2021-02-05","2023-07-11","2022-08-17","2022-11-06","2022-11-06","2022-11-06","2023-01-04","2023-05-09","2023-05-09","2023-05-09","2022-11-14","2022-01-06","2022-11-14","2022-11-14","2022-09-08","2022-09-08","2022-11-14","2022-11-14","2023-03-15","2021-11-07","2021-11-07","2022-08-08","2023-04-24","2022-01-25","2023-02-09","2023-02-09","2023-06-16","2023-07-11","2023-06-16","2023-06-16","2023-06-16","2023-07-11"],"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":[["","65162011510","HYDROCO\/APAP","TAB 7.5-325","20","Select","Select",""],["","68180086573","BLISOVI FE","TAB 44946","28","Select","Select",""],["","16714043901","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","73302045601","ELLA","TAB 30MG","1","Select","Select",""],["","00555901658","SPRINTEC 28","TAB 28 DAY","112","Select","Select",""],["","68180084073","NORGEST\/ETHI","TAB 0.25\/35","112","Select","Select",""],["","50228018001","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","50111078810","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","50102022023","AUBRA EQ","TAB 0.1-0.02","112","Select","Select",""],["","11534018701","BUT\/APAP\/CAF","CAP ","10","Select","Select",""],["","16714035904","FALMINA","TAB ","112","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","68180087773","JENCYCLA","0.35 MG","84","Select","Select",""],["","65162011510","HYDROCO\/APAP TAB","7.5-325","20","Select","Select",""],["","68180086573","BLISOVI FE TAB","1\/20","28","Select","Select",""],["","65162047810","NITROFURANTN CAP","100MG","10","Select","Select",""],["","00555901658","SPRINTEC","28 TAB 28 DAY","112","Select","Select",""],["","73302045601","ELLA TAB","30MG","1","Select","Select",""],["","68180084073","NORGEST\/ETHI TAB","0.25\/35","112","Select","Select",""],["","11534018701","BUT\/APAP\/CAF CAP","","10","Select","Select",""],["","50228018001","GABAPENTIN CAP","300MG","90","Select","Select",""],["","50111078810","AZITHROMYCIN TAB","500MG","2","Select","Select",""],["","67877021901","CEPHALEXIN CAP","500MG","14","Select","Select",""],["","65862039010","ONDANSETRON TAB","4MG ODT","10","Select","Select",""],["","50102022023","AUBRA EQ TAB","0.1-0.02","112","Select","Select",""],["","65862007701","CIPROFLOXACN TAB","500MG","14","Select","Select",""],["","16714035904","FALMINA TAB","","112","Select","Select",""],["","72516003001","METOPROLOL SUCCINATE","25 MG","24","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":""}]}]}