{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CRAIG   S SPECTOR","gend":0,"add":"4801 POOL SIDE ROAD","city":"VIRGINIA BEACH","state":"VA","zip":"23455-9998","dob":"1958-07-16","age":"","mstatus":"","insh":"20035416*01","cliId":"","pno":3102009002,"cno":3102009002,"email":"","ename":"","eno":"","pphy":"KING, JODY P MD","ppno":7574468920,"pcpadd":"SUITE 445 825 FAIRFAX AVENUE","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23507-9998","pcpcounty":"","pcpid":"","pcpname":"EVMS Internal Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574465242,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C61.","C78.6","C79.51","R53.83","E55.9","N52.9","Z79.899","Z79.818","M89.9","M79.604","Z98.890","E11.9","E78.5","K76.0","G89.3","Z51.0","Z08.","D17.79","Z85.46","Z85.830","Z85.89","G89.29","J06.9","H25.813","K59.00"],"date":["2023-03-20","2022-10-05","2023-01-18","2021-12-30","2023-02-20","2021-08-25","2021-02-19","2021-12-03","2021-12-03","2021-12-15","2021-12-15","2022-05-05","2022-05-05","2022-05-05","2022-05-05","2021-04-07","2021-12-15","2021-12-15","2021-12-15","2021-12-15","2021-12-15","2021-02-01","2021-11-20","2021-01-06","2022-02-09"],"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":[["","00469012599","XTANDI","40 MG","90","Select","Select",""],["","10702005601","OXYCODONE","TAB 10MG","120","Select","Select",""],["","68180063609","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","00093342601","LORAZEPAM","1 MG","60","Select","Select",""],["","59267102503","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","72974012001","ORGOVYX","TAB 120MG","30","Select","Select",""],["","62332025118","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00006483703","PNEUMOVAX 23","INJ 25\/0.5","0","Select","Select",""],["","82607066026","FLOWFLEX","KIT TEST","8","Select","Select",""],["","00093216568","NALOXONE HCL","SPR ","2","Select","Select",""],["","49281072210","FLUBLOK QUAD","INJ 2022-23","0","Select","Select",""],["","45802006435","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","51224010750","METFORMIN","TAB 750MG ER","30","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","10702005601","OXYCODONE HCL","10 MG","120","Select","Select",""],["","42806071401","BENZONATATE","100 MG","30","Select","Select",""],["","60505257909","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":""}]}]}