{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EDWARD D PITTMAN","gend":0,"add":"147 CRATER WOODS CT","city":"PETERSBURG","state":"VA","zip":"23805-9998","dob":"1984-01-14","age":"","mstatus":"","insh":"20033452*01","cliId":"","pno":4343903991,"cno":4343903991,"email":"","ename":"","eno":"","pphy":"FAROOQ, AUSMA M DO","ppno":8046441333,"pcpadd":"930 SOUTH AVE SUITE 11","pcpcity":"COLONIAL HEIGHTS","pcpstate":"VA","pcpzip":"23834-9998","pcpcounty":"","pcpid":"","pcpname":"Primary Health Group - Appomattox","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8045048026,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K62.89","I10.","E78.00","E11.9","F41.8","R05.9","F33.9","K64.4","S20.462A","F41.9","R04.0","R09.81","R68.2","E78.5","Z79.899","Z87.891","Z91.148","K60.2","F33.1","Z79.82","G89.29","F32.9","E66.9","Z76.89","Z00.00","G47.33","F91.3","K08.89","J96.01","Z68.41","M79.671","F12.20"],"date":["2021-09-13","2023-05-09","2021-10-20","2023-05-09","2021-10-20","2021-10-20","2022-11-30","2021-07-19","2023-04-27","2023-04-27","2023-05-09","2023-05-09","2023-05-09","2023-05-09","2023-05-09","2023-05-09","2023-05-09","2021-10-20","2021-06-13","2021-09-13","2021-09-13","2021-06-13","2022-06-13","2021-01-25","2021-01-25","2021-01-25","2022-02-03","2022-06-13","2022-06-13","2022-06-13","2022-11-05","2021-12-13"],"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":[["","68180035209","SERTRALINE","TAB 50MG","90","Select","Select",""],["","53885024450","ONETOUCH","TES ULTRA","50","Select","Select",""],["","38415010028","LANCETS","MIS ","100","Select","Select",""],["","27241000150","RISPERIDONE","1 MG","30","Select","Select",""],["","55111012205","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","00406048401","APAP\/CODEINE","TAB 300-30MG","16","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","68180097903","LISINOPRIL","40 MG","30","Select","Select",""],["","00093117410","PENICILLN VK","TAB 500MG","28","Select","Select",""],["","00093005801","TRAMADOL HCL","TAB 50MG","12","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","2","Select","Select",""],["","00378117591","BUSPIRONE","TAB 30MG","60","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","28","Select","Select",""],["","43386035701","HYDROCO\/APAP","TAB 7.5-325","8","Select","Select",""],["","49483060250","IBUPROFEN","TAB 400MG","20","Select","Select",""],["","00093520006","BUSPIRONE HCL","30 MG","60","Select","Select",""],["","62135098505","DOXYCYCLINE HYCLATE","100 MG","20","Select","Select",""],["","69097083412","SERTRALINE HCL","50 MG","30","Select","Select",""],["","43598083105","ATORVASTATIN CALCIUM","20 MG","30","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":""}]}]}