{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MELISSA L DAVIS","gend":1,"add":"81 MESSICK RD APT 105","city":"POQUOSON","state":"VA","zip":"23662-9998","dob":"1966-08-25","age":"","mstatus":"","insh":"20067924*01","cliId":"","pno":7579318974,"cno":7579318974,"email":"","ename":"","eno":"","pphy":"SHAFER, KINDRA L NP","ppno":7573695784,"pcpadd":"1405 KILN CREEK PARKWAY STE K,","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":"23602-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7573695785,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S52.501A","W22.01XA","F17.210","S22.32XA","N17.9","R30.0","R07.9","I10.","E16.1","E16.2","R52.","F29.","R09.02","R07.89","R58.","R61.","H35.62","H35.3112","H25.13","Z86.69","F15.159","S22.31XA","NO DATA","F43.10","E78.5","K21.9","J45.909","K59.00","R51.9","F13.20","F41.1","F33.1","I44.4","I45.10","Z02.2","E55.9","F17.200","J44.9","M54.9","G43.909","V54.12","F32.9","F22.","F15.959","R10.31","Z20.822","T50.904A","T88.7XXA","T50.992A","R60.9","E86.0","R20.2","F54.","R11.2","D72.829","K58.9","Z53.29","Z98.51","T43.621A","F33.2","N30.00","F15.151","F90.9","F41.9","M19.90","H91.90","F13.10","R44.3","T42.4X2A","S52.571A","E87.6","Z00.8","T14.90XA","Z79.51","Z79.899","H35.3220"],"date":["2021-12-20","2021-09-22","2023-06-02","2021-12-19","2022-08-08","2022-08-08","2022-08-08","2023-06-02","2021-12-16","2021-12-16","2021-12-16","2021-12-27","2022-08-04","2022-08-04","2022-08-04","2022-08-04","2022-12-19","2023-06-20","2023-06-20","2023-06-20","2021-12-20","2021-12-20","2023-06-02","2022-02-26","2023-06-02","2023-06-02","2021-12-20","2021-12-20","2023-06-02","2022-02-26","2022-02-26","2022-02-26","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2022-08-04","2023-06-02","2021-09-08","2023-06-02","2021-09-08","2021-09-08","2023-03-26","2022-08-05","2023-03-26","2023-03-26","2021-09-07","2021-09-07","2021-09-07","2021-09-07","2022-08-04","2022-08-04","2022-08-04","2023-03-26","2023-03-26","2023-03-26","2023-03-26","2023-03-26","2022-08-04","2022-08-04","2022-08-04","2022-08-04","2022-08-04","2022-08-04","2022-08-04","2022-08-04","2022-08-04","2022-08-08","2021-09-07","2021-09-07","2021-09-07","2021-12-16","2021-12-24","2023-06-02","2023-06-02","2023-06-20"],"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":[["","27241009903","DULOXETINE","CAP 60MG","30","Select","Select",""],["","70954001910","PRAZOSIN HCL","CAP 1MG","60","Select","Select",""],["","65862052305","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","60","Select","Select",""],["","69680011225","CYANOCOBALAM","INJ 1000MCG","2","Select","Select",""],["","57664051083","MIRTAZAPINE","TAB 7.5MG","30","Select","Select",""],["","13668001105","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","11534018701","BUT\/APAP\/CAF","CAP ","30","Select","Select",""],["","55111064501","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","13107008405","LORAZEPAM","TAB 1MG","14","Select","Select",""],["","00172392670","DIAZEPAM","TAB 5MG","20","Select","Select",""],["","65862086001","FAMOTIDINE","TAB 40MG","180","Select","Select",""],["","49884023183","PRAZIQUANTEL","TAB 600MG","1","Select","Select",""],["","43598045202","ALBENDAZOLE","TAB 200MG","2","Select","Select",""],["","65862050320","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","20","Select","Select",""],["","00143122701","DICYCLOMINE HCL","20 MG","60","Select","Select",""],["","70010075401","METHOCARBAMOL","500 MG","40","Select","Select",""],["","63824005634","MUCINEX DM","600MG-30MG","28","Select","Select",""],["","70710113908","FLUCONAZOLE","150 MG","2","Select","Select",""],["","11822046713","ACETAMINOPHEN","325 MG","120","Select","Select",""],["","27241009903","DULOXETINE CAP","60MG","30","Select","Select",""],["","65862052305","GABAPENTIN TAB","600MG","90","Select","Select",""],["","70954001910","PRAZOSIN HCL CAP","1MG","60","Select","Select",""],["","69680011225","CYANOCOBALAM INJ","1000MCG","2","Select","Select",""],["","00143122701","DICYCLOMINE TAB","20MG","60","Select","Select",""],["","68180098103","LISINOPRIL TAB","20MG","90","Select","Select",""],["","57664051083","MIRTAZAPINE TAB","7.5MG","30","Select","Select",""],["","13668001105","CITALOPRAM TAB","40MG","30","Select","Select",""],["","55111064501","OMEPRAZOLE CAP","40MG","30","Select","Select",""],["","11534018701","BUT\/APAP\/CAF CAP","","30","Select","Select",""],["","00172392670","DIAZEPAM TAB","5MG","20","Select","Select",""],["","13107008405","LORAZEPAM TAB","1MG","14","Select","Select",""],["","65862086001","FAMOTIDINE TAB","40MG","180","Select","Select",""],["","49884023183","PRAZIQUANTEL TAB","600MG","1","Select","Select",""],["","43598045202","ALBENDAZOLE TAB","200MG","2","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":""}]}]}