{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CALVIN S COLEY","gend":0,"add":"5412 SWEETWATER CT","city":"VIRGINIA BEACH","state":"VA","zip":"23462-9998","dob":"1964-07-24","age":"","mstatus":"","insh":"20071559*01","cliId":"","pno":9196560770,"cno":9196560770,"email":"","ename":"","eno":"","pphy":"LOVELL JR, CHARLES F MD","ppno":7576233038,"pcpadd":"142 W YORK ST #905,","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23510-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576230101,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","F11.23","NO DATA","M19.071","M25.571","M76.821","Q66.50","M21.6X9","Q66.41","M79.671","B35.1","I50.9","M96.1","G95.9","R41.82","R51.9","F11.90","D64.9","E11.9","I10.","B19.20","Z88.0","M48.02","M47.812","Z68.39","E11.40","I11.9","M19.90","Z79.84","Z79.899","Z88.1","M79.606","M10.9","R73.09","E78.2","B18.2","N39.0","E83.59","M24.572","M77.32","B35.3","M79.672","M72.2","G95.19","E55.9","M19.072","M15.9","R53.83","F51.09","K42.9","R07.9","N13.9","Z79.82","M79.89","H60.91","J02.9"],"date":["2022-08-16","2022-07-30","2022-07-27","2022-07-22","2021-12-01","2022-04-11","2022-04-11","2022-04-11","2022-04-11","2022-04-11","2022-04-11","2021-05-21","2022-02-02","2022-02-02","2022-07-23","2022-07-23","2022-07-23","2022-07-23","2022-07-30","2023-08-14","2022-07-30","2022-07-23","2022-02-01","2022-02-01","2022-02-01","2022-07-30","2022-07-30","2022-07-30","2022-07-30","2022-07-30","2022-07-30","2022-07-30","2022-08-30","2022-08-30","2022-08-30","2022-08-30","2021-10-26","2022-03-18","2021-06-29","2021-06-29","2021-06-29","2021-06-29","2021-06-29","2022-02-01","2022-07-22","2022-07-22","2022-07-23","2022-07-23","2022-07-23","2022-07-23","2022-07-30","2022-08-30","2021-05-30","2021-05-30","2023-08-14","2023-08-14"],"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":[["","45802051377","AMMONIUM LAC CRE","12%","140","Select","Select",""],["","45802014167","CICLOPIROX SOL","8%","7","Select","Select",""],["","68180044601","QUETIAPINE TAB","50MG","14","Select","Select",""],["","75826013910","PHENOBARB TAB","32.4MG","18","Select","Select",""],["","42806054701","VITAMIN D CAP","1.25MG","2","Select","Select",""],["","52817019610","TRAMADOL HCL TAB","100MG","18","Select","Select",""],["","81131007181","FISH OIL CAP","1000MG","14","Select","Select",""],["","50228018105","GABAPENTIN CAP","400MG","18","Select","Select",""],["","68462025501","ROPINIROLE TAB","1MG","42","Select","Select",""],["","68382013201","TAMSULOSIN CAP","0.4MG","30","Select","Select",""],["","59746000103","METHYLPRED TAB","4MG","21","Select","Select",""],["","45802014167","CICLOPIROX","SOL 0.08","7","Select","Select",""],["","45802051377","AMMONIUM LAC","CRE 0.12","140","Select","Select",""],["","81131007181","FISH OIL","CAP 1000MG","14","Select","Select",""],["","57664037708","TRAMADOL HCL","TAB 50MG","56","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","42806054701","VITAMIN D","CAP 1.25MG","2","Select","Select",""],["","68462025501","ROPINIROLE","TAB 1MG","42","Select","Select",""],["","50228018105","GABAPENTIN","CAP 400MG","18","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","68180044601","QUETIAPINE","TAB 50MG","14","Select","Select",""],["","75826013910","PHENOBARB","TAB 32.4MG","18","Select","Select",""],["","42571016242","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","20","Select","Select",""],["","24208063562","NEOMYCIN-POLYMYXIN-HC","3.5-10K-1","10","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":""}]}]}