{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LOUISE LAVEY","gend":1,"add":"5642 GREGORY CT","city":"PORTSMOUTH","state":"VA","zip":"23703-9998","dob":"1960-04-27","age":"","mstatus":"","insh":"20040298*01","cliId":"","pno":7572971092,"cno":7572971092,"email":"","ename":"","eno":"","pphy":"LATIMER, KELLY M MD","ppno":7574465955,"pcpadd":"825 FAIRFAX AVE STE 118,","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23507-9998","pcpcounty":"","pcpid":"","pcpname":"EVMS Ghent Family Medicine","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574465196,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I16.0","I10.","Z20.828","NO DATA","N30.01","M76.71","M20.11","M19.071","M25.571","F43.12","H02.055","H25.13","H43.393","H35.033","H53.40","I63.032","I65.23","I69.321","I69.920","I63.9","F30.9","R47.1","H35.039","H16.223","E78.5","M81.0","Z12.11","Z20.822","R39.9","S39.012A","F32.0","M54.9"],"date":["2022-04-06","2022-10-06","2022-04-06","2023-07-11","2022-09-24","2021-10-12","2021-10-12","2021-10-12","2021-10-12","2023-07-15","2021-05-25","2021-08-03","2021-08-03","2021-05-25","2021-08-03","2022-09-15","2022-09-30","2022-01-11","2022-09-15","2022-04-01","2022-04-01","2022-04-01","2021-08-03","2021-08-03","2021-07-27","2021-07-27","2021-07-27","2022-08-03","2022-10-06","2022-04-12","2023-06-08","2023-06-29"],"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":[["","00363056314","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","16500055016","ONE-A-DAY","TAB 50+ ADV","30","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","90","Select","Select",""],["","68180051303","LISINOPRIL","5 MG","90","Select","Select",""],["","00378395305","ATORVASTATIN","TAB 80MG","90","Select","Select",""],["","11917019864","PAIN RELIEVI","PAD LIDOCAIN","30","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00363041414","ASPIRIN","TAB 81MG EC","90","Select","Select",""],["","00115164501","NITROFUR MAC","CAP 100MG","10","Select","Select",""],["","42571016242","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","19515080852","FLULAVAL QUA","INJ 2022-23","0","Select","Select",""],["","16500055016","ONE-A-DAY WOMEN'S","50+ 400-500-20","60","Select","Select",""],["","43598083305","ATORVASTATIN CALCIUM","80 MG","90","Select","Select",""],["","00363041414","ASPIRIN EC","81 MG","90","Select","Select",""],["","00363056314","ASPIRIN LOW TAB","81MG EC","30","Select","Select",""],["","16500055016","ONE-A-DAY TAB","50+ ADV","30","Select","Select",""],["","50111064801","FLUOXETINE CAP","20MG","90","Select","Select",""],["","69097052444","DICLOFENAC GEL","1%","100","Select","Select",""],["","00378395305","ATORVASTATIN TAB","80MG","90","Select","Select",""],["","68180051303","LISINOPRIL TAB","5MG","90","Select","Select",""],["","11917019864","PAIN RELIEVI PAD LIDOCAIN","","30","Select","Select",""],["","00591352530","LIDOCAINE PAD","5%","30","Select","Select",""],["","00363041414","ASPIRIN TAB","81MG EC","90","Select","Select",""],["","42571016242","AMOX\/K CLAV TAB","875-125","20","Select","Select",""],["","00115164501","NITROFUR MAC CAP","100MG","10","Select","Select",""],["","19515080852","FLULAVAL QUA INJ","2022-23","0","Select","Select",""],["","29300041301","CYCLOBENZAPRINE HCL","5 MG","10","Select","Select",""],["","16571020310","DICLOFENAC SODIUM","25 MG","21","Select","Select",""],["","50111064801","FLUOXETINE HCL","20 MG","30","Select","Select",""],["","60505082306","CALCITONIN-SALMON","200\/SPRAY","3.7","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":""}]}]}