{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEBORAH  L CENICEROS","gend":1,"add":"17 SMITH LAKE DR","city":"STAFFORD","state":"VA","zip":"22556-9998","dob":"1960-07-06","age":"","mstatus":"","insh":"20061422*01","cliId":"","pno":5402887681,"cno":5402887681,"email":"","ename":"","eno":"","pphy":"MANDEVILLE, JOHN D DO","ppno":5407350560,"pcpadd":"SUITE 100 1965 JEFFERSON DAVIS HIGH","pcpcity":"FREDERICKSBURG","pcpstate":"VA","pcpzip":"22401-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5407350567,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R09.02","I46.9","J20.9","R06.02","J44.1","M54.16","Z79.891","Z51.81","M54.12","M41.80","M17.10","M54.14","Z09.","NO DATA","M54.9","R53.81","M50.10","R07.9","M41.129","R09.2","J96.01","J69.0","T40.2X1A","G93.41","J45.901","F14.10","F17.210","Z53.29","Z20.822","M94.0","R07.89","H25.12","R51.9","H40.053","J44.0","M54.5","M25.562","R40.1","Z99.89","J90.","G89.29","D72.829","J44.9","R03.0","G89.4","M53.3","F17.200"],"date":["2022-03-10","2022-03-10","2022-07-17","2022-07-17","2023-03-05","2022-11-04","2022-10-07","2022-10-07","2022-11-04","2022-03-21","2022-03-21","2022-11-04","2022-10-07","2022-06-29","2022-06-29","2022-09-09","2022-09-09","2022-03-09","2022-05-16","2022-03-10","2022-03-10","2022-03-10","2022-03-10","2022-03-10","2022-03-10","2022-03-10","2022-03-16","2022-03-10","2022-07-17","2022-03-10","2022-03-16","2022-06-28","2022-06-28","2022-06-28","2022-07-17","2021-09-21","2021-09-21","2022-03-09","2022-03-09","2022-03-16","2022-09-28","2022-03-16","2022-03-16","2022-03-16","2022-06-13","2022-09-28","2022-09-28"],"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":[["","59676058015","JANSSEN VACC","INJ COVID-19","0","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","12","Select","Select",""],["","47335075649","IPRATROPIUM\/","SOL ALBUTER","60","Select","Select",""],["","72888000801","TRAMADOL HCL","100 MG","6","Select","Select",""],["","62332014231","CELECOXIB","CAP 200MG","60","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","21","Select","Select",""],["","65862050320","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00093216568","NALOXONE HCL","SPR ","2","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","21","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","27241009706","DULOXETINE","CAP 20MG","30","Select","Select",""],["","13668013501","ESCITALOPRAM","TAB 5MG","30","Select","Select",""],["","00378827052","ALBUTEROL","NEB 0.00083","75","Select","Select",""],["","24658031205","DOXYCYCL HYC","TAB 100MG","14","Select","Select",""],["","68462019005","NAPROXEN","500 MG","14","Select","Select",""],["","76204020025","ALBUTEROL SULFATE","2.5 MG\/3ML","75","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":""}]}]}