{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA ALLEN","gend":1,"add":"7903 W GLEN ROAD","city":"NORFOLK","state":"VA","zip":"23505-9998","dob":"1964-02-15","age":"","mstatus":"","insh":"20041650*01","cliId":"","pno":7578392418,"cno":7578392418,"email":"","ename":"","eno":"","pphy":"PARKER, REBECCA M NP","ppno":7576898460,"pcpadd":"SUITE 100 1925 GLENN MITCHELL DR,","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23456-9998","pcpcounty":"","pcpid":"","pcpname":"Princess Anne Medical Associates","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576898435,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M96.1","M47.814","G89.4","M47.816","M47.896","M54.16","M53.3","F43.12","Z98.1","Z79.899","NO DATA","Z53.20","Z00.00","E55.9","M25.50","Z13.220","F32.9","F41.9","J30.9","U07.1","R07.89","J06.9","J45.20","M46.1","M43.26","J01.00","M51.16","M47.26","M25.78","M51.34","Z01.818","Z20.822","M51.36","Z20.828","M43.06","Z88.0","Z88.1","Z88.2","R07.9"],"date":["2022-11-03","2021-05-18","2023-07-12","2022-10-06","2021-07-28","2023-01-24","2023-03-06","2021-01-12","2022-06-09","2021-06-17","2021-12-09","2021-08-14","2021-12-09","2021-12-09","2021-12-09","2021-12-09","2021-12-09","2021-12-09","2021-12-09","2022-01-18","2022-01-09","2022-01-09","2022-01-09","2023-07-12","2023-07-12","2021-02-11","2022-06-09","2022-06-09","2022-06-09","2022-06-09","2021-07-19","2021-07-26","2022-05-05","2021-01-29","2021-07-28","2022-01-09","2022-01-09","2022-01-09","2022-01-09"],"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":[["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","62332014131","CELECOXIB","100 MG","180","Select","Select",""],["","69097083305","SERTRALINE","TAB 25MG","90","Select","Select",""],["","00904698640","MUCUS RELIEF","TAB 600MG ER","60","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","4","Select","Select",""],["","59310057922","PROAIR HFA","AER ","17","Select","Select",""],["","00093005805","TRAMADOL HCL","50 MG","28","Select","Select",""],["","69097094312","GABAPENTIN","300 MG","60","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","17","Select","Select",""],["","47335075649","IPRATROPIUM\/","SOL ALBUTER","360","Select","Select",""],["","43386035801","HYDROCO\/APAP","TAB 10-325MG","60","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","18","Select","Select",""],["","60505025103","TIZANIDINE","TAB 2MG","90","Select","Select",""],["","69842080601","CVS MUCUS ER","TAB 600MG","60","Select","Select",""],["","16571040250","CETIRIZINE HCL","10 MG","30","Select","Select",""],["","53746011001","HYDROCODONE-ACETAMINOPHEN","10MG-325MG","60","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","Select","Select",""],["","60505025103","TIZANIDINE HCL","2 MG","90","Select","Select",""],["","69097017353","IPRATROPIUM-ALBUTEROL","0.5-3MG\/3","360","Select","Select",""],["","69452034572","SUMATRIPTAN SUCCINATE","50 MG","9","Select","Select",""],["","59310058020","PROAIR RESPICLICK","90 MCG","1","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":""}]}]}