{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHEILA BORELL","gend":1,"add":"3408 E OCEAN VIEW AVE APT # 5","city":"NORFOLK","state":"VA","zip":"23518-9998","dob":"1954-12-20","age":"","mstatus":"","insh":"20038133*01","cliId":"","pno":7573625323,"cno":7573625323,"email":"","ename":"","eno":"","pphy":"OLDFIELD, EDWARD C MD","ppno":4468912,"pcpadd":"825 FAIRFAX AVE","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23507-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","F12.10","B20.","R79.81","I10.","B18.2","M81.0","M25.579","F17.200","R30.0","E88.1","Z23.","Z13.31","I73.00","K13.0"],"date":["2023-04-01","2023-04-01","2023-02-01","2022-05-16","2023-02-01","2023-02-01","2023-02-01","2023-02-01","2022-11-02","2021-02-15","2022-11-02","2022-11-02","2021-11-29","2021-11-29","2021-11-29"],"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":[["","61958200201","DESCOVY","TAB 200\/25MG","30","Select","Select",""],["","42858086806","DRONABINOL","CAP 5MG","30","Select","Select",""],["","69618003806","OYST SHELL\/D","TAB 500-200","60","Select","Select",""],["","00074333330","NORVIR","TAB 100MG","30","Select","Select",""],["","68180071909","AMLODIPINE","TAB 2.5MG","30","Select","Select",""],["","69097044602","ATAZANAVIR","CAP 300MG","30","Select","Select",""],["","16714063301","ALENDRONATE","TAB 70MG","4","Select","Select",""],["","65862004930","EFAVIRENZ","TAB 600MG","30","Select","Select",""],["","65862068730","RITONAVIR","TAB 100MG","30","Select","Select",""],["","16571078101","CARISOPRODOL","350 MG","90","Select","Select",""],["","00378877035","ESTRADIOL","CRE 0.0001","42","Select","Select",""],["","47781030801","NITROFUR MAC","CAP 100MG","10","Select","Select",""],["","69452015120","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","61958250101","BIKTARVY","50-200-25","30","Select","Select",""],["","59267030402","PFIZER BIVAL","INJ BA4\/BA5","0","Select","Select",""],["","00904546080","OYSTER SHELL CALCIUM-VIT D","3 500MG-5MCG","60","Select","Select",""],["","16714063301","ALENDRONATE SODIUM","70 MG","4","Select","Select",""],["","68180071909","AMLODIPINE BESYLATE","2.5 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":""}]}]}