{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BEVERLY GIBSON","gend":1,"add":"9620 CHESAPEAKE BLVD APT 14","city":"NORFOLK","state":"VA","zip":"23503-9998","dob":"1977-07-29","age":"","mstatus":"","insh":"20081539*01","cliId":"","pno":7576479825,"cno":7576479825,"email":"","ename":"","eno":"","pphy":"MURRAY, KEVIN MD","ppno":7576228358,"pcpadd":"930 W 21ST ST","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23517-9998","pcpcounty":"","pcpid":"","pcpname":"Depaul Medical Associates","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576229662,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25.551","M54.40","Z01.00","M54.16","M54.12","M62.830","M54.17","M48.07","M43.17","K91.1","I10.","Z68.21","H90.41","H69.91","R42.","E10.9","Z85.028","Z79.4","Z88.0","Z88.2","R20.0","K91.2","R20.2","R11.0","D50.8","R10.13","Z98.84","Z86.39","Z68.22","S80.02XA","M25.562","R32.","Z68.24","J06.9","Z20.828","H91.91","R53.82","H65.01","U09.9","E53.8","E55.9","E03.8","E51.9","M54.41","NO DATA","M51.36","M51.17"],"date":["2022-12-13","2022-12-13","2022-12-13","2023-02-07","2023-01-24","2023-01-24","2023-03-16","2023-03-16","2023-03-16","2022-06-02","2022-06-02","2022-06-20","2022-12-09","2022-12-09","2022-12-09","2023-01-24","2023-01-24","2023-01-24","2023-01-24","2023-01-24","2023-01-24","2022-07-06","2022-07-06","2022-07-06","2022-09-21","2022-07-06","2022-07-06","2022-07-06","2022-07-06","2022-11-10","2022-11-09","2023-02-07","2023-02-07","2022-02-25","2022-02-25","2022-09-06","2022-09-06","2022-09-06","2022-09-06","2022-06-20","2022-06-20","2022-06-20","2022-06-20","2022-12-28","2022-12-28","2023-02-24","2023-03-16"],"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":[["","43547028110","ESCITALOPRAM","TAB 10MG","90","Select","Select",""],["","68382050010","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","11523433201","CLARITIN-D","TAB 10-240MG","60","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","20","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","65862092205","TRAMADL\/APAP","TAB 37.5-325","15","Select","Select",""],["","70010077001","METHOCARBAMOL","750 MG","60","Select","Select",""],["","00172392670","DIAZEPAM","5 MG","12","Select","Select",""],["","65162062750","TRAMADOL HCL","50 MG","9","Select","Select",""],["","00591544210","PREDNISONE","10 MG","26","Select","Select",""],["","43547028110","ESCITALOPRAM OXALATE","10 MG","90","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":""}]}]}