{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHAUN RIGGIN","gend":0,"add":"11 E DUNCAN DR LOT 2","city":"HAMPTON","state":"VA","zip":"23663-9998","dob":"1991-11-19","age":"","mstatus":"","insh":"20045021*01","cliId":"","pno":7579150431,"cno":7579150431,"email":"","ename":"","eno":"","pphy":"KNUST, LISA M MD","ppno":7572387043,"pcpadd":"13478 CARROLLTON BOULEVARD STE D &,","pcpcity":"CARROLLTON","pcpstate":"VA","pcpzip":"23314-9998","pcpcounty":"","pcpid":"","pcpname":"Eagle Harbor Primary Care","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7572387052,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.9","F84.0","F43.12","F90.2","M54.16","M54.41","M51.36","M47.816","M53.3","G89.29","Z79.1","M79.606","M54.5","K02.9","K05.10","R05.3","R06.02","R05.8","R07.89","R06.2","D72.829","R42.","R09.89","Z72.0","F12.90","Z82.49","Z86.16","Z79.899","L60.0","E78.1","NO DATA","K21.9","J01.00","F17.210","M54.31","Z00.00","B35.1","J30.9","R07.9"],"date":["2021-07-08","2022-06-30","2021-07-08","2021-07-08","2022-02-16","2021-05-11","2023-09-06","2021-05-11","2021-06-14","2022-02-16","2021-05-11","2021-05-11","2021-07-13","2021-10-01","2021-10-01","2022-06-30","2022-06-30","2022-06-30","2022-06-30","2022-06-30","2022-06-30","2022-06-30","2022-06-30","2022-06-30","2022-06-30","2022-06-30","2022-06-30","2022-06-30","2023-09-06","2023-09-06","2023-09-06","2023-09-06","2021-03-25","2022-02-16","2021-03-25","2022-02-16","2022-02-16","2022-02-16","2022-06-30"],"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":[["","29300022019","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","31722066530","ESOMEPRA MAG","CAP 40MG DR","30","Select","Select",""],["","45802010901","TRIAMCINOLON","AER 55MCG\/AC","17","Select","Select",""],["","65862007930","TERBINAFINE","TAB 250MG","30","Select","Select",""],["","68462039610","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","69238110005","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","59746017506","PREDNISONE","TAB 20MG","15","Select","Select",""],["","64380071206","BENZONATATE","CAP 100MG","30","Select","Select",""],["","57237002801","AMOXICILLIN","500 MG","30","Select","Select",""],["","72888001405","CYCLOBENZAPRINE HCL","10 MG","30","Select","Select",""],["","42806041430","BUPROPION XL","150 MG","30","Select","Select",""],["","31722071390","PANTOPRAZOLE SODIUM","40 MG","30","Select","Select",""],["","65162046550","IBUPROFEN","600 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":""}]}]}