{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ARNEISHA  R ARTIS","gend":1,"add":"5311 LIBERTYVILLE ROAD","city":"CHESAPEAKE","state":"VA","zip":"23320-9998","dob":"1998-04-27","age":"","mstatus":"","insh":"20023290*01","cliId":"","pno":7574947465,"cno":7574947465,"email":"","ename":"","eno":"","pphy":"MEDALLA, AILENE D MD","ppno":7575480076,"pcpadd":"725 VOLVO PKWY STE 100,","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":"23320-9998","pcpcounty":"","pcpid":"","pcpname":"Volvo Medical Associates","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7575481652,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R55.","F31.70","I10.","E66.01","R63.5","E55.9","E61.1","F31.9","F31.5","K21.9","L30.9","L21.9","D50.8","D70.8","D72.820","F31.32","M25.572","M25.571","Z13.1","Z23.","Z13.220","Z13.29","M21.961","Z20.822","J06.9","J02.9","H92.02","Z00.00","F90.9","Z30.09","Z79.899","M21.41","F90.0","E86.0","R10.2","R61.","I49.9","T67.1XXA","R11.2","I49.8","F20.9","E66.9","Z68.42","Z86.711","T67.5XXA"],"date":["2021-07-11","2022-03-31","2023-03-02","2023-03-02","2022-11-16","2023-03-02","2023-03-02","2023-07-06","2021-10-07","2023-03-02","2023-03-02","2023-03-02","2022-03-31","2022-03-31","2022-04-21","2022-04-29","2021-08-20","2021-08-20","2021-10-14","2022-11-16","2023-03-02","2021-10-14","2022-06-27","2021-05-25","2021-05-25","2021-05-25","2021-05-25","2023-03-02","2023-07-04","2021-07-02","2023-07-04","2022-09-28","2023-01-23","2023-07-04","2021-08-11","2021-08-11","2023-07-04","2023-07-04","2023-07-04","2023-07-04","2023-07-04","2023-07-04","2023-07-04","2023-07-04","2023-07-04"],"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":[["","59417010510","VYVANSE","50 MG","30","Select","Select",""],["","60505392801","GUANFACINE","TAB 2MG ER","30","Select","Select",""],["","43547034406","RISPERIDONE","4 MG","30","Select","Select",""],["","00245010810","FERROUS SULF","TAB 325MG EC","45","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","90","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","15","Select","Select",""],["","42806054701","VITAMIN D","2 1250 MCG","12","Select","Select",""],["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","00781598701","CARBAMAZEPIN","TAB 200MG ER","120","Select","Select",""],["","00078051105","TEGRETOL-XR","TAB 200MG","120","Select","Select",""],["","70436001004","BUPROPN HCL","TAB 150MG XL","30","Select","Select",""],["","00713022315","FLUOCIN ACET","CRE 0.0001","60","Select","Select",""],["","51672418803","BETAMETH VAL","AER 0.0012","50","Select","Select",""],["","62332054804","CLOBETASOL","SHA 0.0005","118","Select","Select",""],["","55111064505","OMEPRAZOLE","40 MG","30","Select","Select",""],["","68180013501","ESCITALOPRAM OXALATE","10 MG","30","Select","Select",""],["","00172208380","HYDROCHLOROTHIAZIDE","25 MG","90","Select","Select",""],["","60505392801","GUANFACINE HCL ER","2 MG","30","Select","Select",""],["","31722070090","LOSARTAN POTASSIUM","25 MG","30","Select","Select",""],["","62332054804","CLOBETASOL PROPIONATE","0.05 %","118","Select","Select",""],["","59417010710","VYVANSE CAP","70MG","30","Select","Select",""],["","60505392801","GUANFACINE TAB","2MG ER","30","Select","Select",""],["","43547034406","RISPERIDONE TAB","4MG","30","Select","Select",""],["","00245010810","FERROUS SULF TAB","325MG EC","15","Select","Select",""],["","16729018201","HYDROCHLOROT TAB","12.5MG","90","Select","Select",""],["","00904759080","FEROSUL TAB","325MG","15","Select","Select",""],["","64380073706","VITAMIN D CAP","50000UNT","12","Select","Select",""],["","59267100002","PFIZER VACC INJ COVID-","19","0","Select","Select",""],["","00078051105","TEGRETOL-XR TAB","200MG","120","Select","Select",""],["","00781598701","CARBAMAZEPIN TAB","200MG ER","120","Select","Select",""],["","70436001004","BUPROPN HCL TAB","150MG XL","30","Select","Select",""],["","51672418803","BETAMETH VAL AER","0.12%","50","Select","Select",""],["","55111064505","OMEPRAZOLE CAP","40MG","30","Select","Select",""],["","00713022315","FLUOCIN ACET CRE","0.01%","60","Select","Select",""],["","62332054804","CLOBETASOL SHA","0.05%","118","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":""}]}]}