{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JEREMY D SANCHEZ","gend":0,"add":"6451 CRESCENT WAY APT 207","city":"NORFOLK","state":"VA","zip":"23513-9998","dob":"1987-12-09","age":"","mstatus":"","insh":"20044551*01","cliId":"","pno":7578313992,"cno":7578313992,"email":"","ename":"","eno":"","pphy":"BRIGHT, RONI J NP","ppno":7574465908,"pcpadd":"855 BRAMBLETON AVE,","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23510-9998","pcpcounty":"","pcpid":"","pcpname":"EVMS Endocrine and Metabolic Disorders","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574467055,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z94.0","I10.","E10.9","E10.319","S05.01XA","H54.8","E10.8","Z79.4","E10.65","E10.42","E78.01","B07.9","E10.3299","Z79.52","N25.81","H90.12","E55.9","I12.9","E11.22","N18.2","H43.11","E11.37X9","E11.3593","Z20.822","E11.65","E11.319","H91.90","H54.7","H43.13","Z68.1","E10.22","NO DATA","E78.5","E16.1","L03.113","I12.0","E87.1","Z79.82","Z82.49","Z83.3","Z87.891","Z88.0","Z88.5","D84.9","M65.849","E10.649"],"date":["2023-05-22","2023-05-22","2023-05-22","2022-11-21","2021-04-13","2022-08-26","2023-09-05","2023-09-05","2022-02-15","2023-04-19","2023-01-13","2022-05-04","2023-04-19","2022-08-26","2023-05-22","2021-11-16","2021-11-16","2021-03-24","2021-03-24","2021-03-24","2021-04-16","2021-10-15","2021-10-15","2021-09-20","2023-04-17","2023-04-19","2021-08-10","2021-08-10","2021-10-15","2021-01-27","2023-04-14","2022-03-23","2022-05-26","2022-05-26","2023-04-17","2023-04-14","2023-04-14","2023-04-14","2023-04-14","2023-04-14","2023-04-14","2023-04-14","2023-04-14","2023-04-16","2023-04-17","2023-09-05"],"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":[["","68645019059","METOPROL TAR","TAB 50MG","90","Select","Select",""],["","00002879959","HUMALOG KWIK","INJ 100\/ML","15","Select","Select",""],["","59746017206","PREDNISONE","5 MG","30","Select","Select",""],["","00378420178","MYCOPHENOLIC","TAB 180MG DR","180","Select","Select",""],["","16729004201","TACROLIMUS","1 MG","150","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","69452015120","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","17478007035","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","08290320550","BD PEN NEEDL","MIS 32GX5\/32","200","Select","Select",""],["","69097022416","ALENDRONATE","TAB 70MG","4","Select","Select",""],["","08484073200","PRODIGY NO","TES CODING","150","Select","Select",""],["","00002614511","BAQSIMI ONE","POW 3MG\/DOSE","1","Select","Select",""],["","00006412102","GARDASIL 9","INJ ","0","Select","Select",""],["","57599080000","FREESTY LIBR","KIT 2 SENSOR","6","Select","Select",""],["","49502039475","INSULIN GLAR","INJ 100U\/ML","15","Select","Select",""],["","60505296507","MYCOPHENOLIC ACID","180 MG","180","Select","Select",""],["","00002879959","HUMALOG KWIKPEN U-","100 100\/ML","15","Select","Select",""],["","00088221905","LANTUS SOLOSTAR","100\/ML (3)","15","Select","Select",""],["","68645019059","METOPROLOL TARTRATE","50 MG","90","Select","Select",""],["","49502039475","INSULIN GLARGINE-YFGN","100\/ML (3)","15","Select","Select",""],["","72065012111","GVOKE HYPOPEN","1-PACK 1 MG\/0.2ML","0.2","Select","Select",""],["","08290320550","NANO","2ND GEN PEN NEEDLE 32GX 5\/32\"","200","Select","Select",""],["","67877021905","CEPHALEXIN","500 MG","14","Select","Select",""],["","00002614511","BAQSIMI","3 MG","1","Select","Select",""],["","31722070090","LOSARTAN POTASSIUM","25 MG","30","Select","Select",""],["","70377000612","ROSUVASTATIN CALCIUM","5 MG","90","Select","Select",""],["","49502025175","SEMGLEE (YFGN) PEN","100\/ML (3)","15","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":""}]}]}