{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LARAYE M JONES","gend":0,"add":"1130 HAMPTON AVE","city":"NEWPORT NEWS","state":"VA","zip":"23607-9998","dob":"1982-05-18","age":"","mstatus":"","insh":"20068095*01","cliId":"","pno":7579752385,"cno":7579752385,"email":"","ename":"","eno":"","pphy":"ELLIOTT, JOY DO","ppno":7575943800,"pcpadd":"10510 JEFFERSON AVENUE STE A","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":"23601-9998","pcpcounty":"","pcpid":"","pcpname":"Riverside Brentwood Medical Center","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7575943818,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.42","D86.9","H15.002","G89.4","G62.9","NO DATA","Z79.899","I12.9","E11.22","K59.00","I10.","N18.2","R80.9","E87.5","Z51.81","Z23.","Z87.448","H40.003","E11.43","Z87.891","K08.89","E11.9","H25.13","H52.13","H52.203","H52.4","I73.9","V58.89","E78.5","Z79.891","K59.03","D86.89","R68.89","E78.2","Z13.1","J84.9","M79.661","M79.662","R39.198"],"date":["2023-04-17","2022-10-18","2021-09-14","2023-04-13","2022-11-29","2022-08-08","2021-09-14","2023-04-17","2023-04-17","2022-10-18","2023-03-15","2023-04-17","2023-04-17","2023-04-17","2021-03-23","2022-09-19","2023-02-01","2022-09-13","2022-02-15","2022-04-05","2022-04-05","2022-05-24","2023-02-28","2022-10-25","2022-05-24","2022-10-25","2021-04-26","2021-04-26","2023-04-13","2023-04-13","2023-04-13","2021-04-07","2023-03-06","2022-05-04","2022-11-29","2021-05-05","2021-10-05","2021-10-05","2023-03-14"],"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":[["","69315012710","FOLIC ACID","1 MG","30","Select","Select",""],["","65862058701","AMLOD\/BENAZP","CAP 10-40MG","90","Select","Select",""],["","68382013210","TAMSULOSIN","CAP 0.4MG","90","Select","Select",""],["","67877069601","CHLORTHALID","TAB 25MG","60","Select","Select",""],["","65162046650","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","70010049105","METFORMIN","TAB 500MG ER","30","Select","Select",""],["","00527131301","PILOCARPINE","TAB 5MG","60","Select","Select",""],["","16729022517","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","72888008000","TRAMADOL HCL","50 MG","120","Select","Select",""],["","70710122701","AMITRIPTYLIN","TAB 50MG","30","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","65862029490","ROSUVASTATIN","TAB 10MG","30","Select","Select",""],["","24208046325","LATANOPROST","0.005 %","2.5","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00536105224","PEG3350","POW ","238","Select","Select",""],["","37000002404","METAMUCIL","POW 0.5812","30","Select","Select",""],["","00406055201","OXYCODONE HCL","5 MG","120","Select","Select",""],["","67877041301","METFORMIN HCL ER","500 MG","30","Select","Select",""],["","62175044215","POLYETHYLENE GLYCOL","3350 17 G\/DOSE","510","Select","Select",""],["","68382013201","TAMSULOSIN HCL","0.4 MG","90","Select","Select",""],["","67877069601","CHLORTHALIDONE","25 MG","60","Select","Select",""],["","65862058701","AMLODIPINE BESYLATE-BENAZEPRIL","10 MG-40MG","90","Select","Select",""],["","72205000390","ROSUVASTATIN CALCIUM","10 MG","30","Select","Select",""],["","00228280111","PILOCARPINE HCL","5 MG","60","Select","Select",""],["","00904699880","DOCUSATE SODIUM","100 MG","60","Select","Select",""],["","16729022501","SPIRONOLACTONE","25 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":""}]}]}