{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA  M TESTERMAN","gend":1,"add":"28312 COLONY DR","city":"PETERSBURG","state":"VA","zip":"23805-9998","dob":"2002-08-23","age":"","mstatus":"","insh":"2069949*01","cliId":"","pno":8049433885,"cno":8049433885,"email":"","ename":"","eno":"","pphy":"MORIN, CAITLIN MD","ppno":8048972100,"pcpadd":"1212 KOGER CENTER BLVD,","pcpcity":"NORTH CHESTERFIELD","pcpstate":"VA","pcpzip":"23235-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8048979074,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["NO DATA","R11.2","N39.0","R31.9","B34.9","F41.8","F33.2","H66.91","J06.9","E11.9","F17.210","J45.909","R05.","R10.84","E66.9","F12.90","Z68.35","U07.1","J20.9","R52.","R10.2","N94.10","N89.8","Z32.02","Z79.899","N61.0","B35.1","Z79.51","R23.9","N90.7","N94.6","S46.911A","Z20.822","F41.0","F41.1","F12.980","R09.81","Z01.419","Z30.41","H40.053","H52.12","H52.223","S60.212A","S60.211A","M25.532","S69.91XA","M79.642"],"date":["2022-01-11","2022-11-19","2022-11-19","2022-11-19","2022-11-19","2023-01-27","2023-02-27","2021-05-15","2022-08-20","2023-05-28","2023-05-28","2023-05-28","2021-05-15","2021-05-25","2021-05-25","2021-05-25","2021-05-25","2022-01-30","2022-01-30","2022-01-30","2022-10-21","2022-10-21","2022-10-21","2022-10-21","2022-01-11","2022-02-03","2022-02-03","2022-08-20","2022-02-03","2022-11-03","2023-02-16","2021-09-20","2022-08-20","2022-01-23","2023-02-27","2021-06-03","2022-08-20","2023-04-06","2023-04-06","2023-05-01","2023-05-01","2023-05-01","2023-05-28","2023-05-28","2023-05-28","2023-05-28","2023-05-28"],"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":[["","65862086001","FAMOTIDINE","TAB 40MG","30","Select","Select",""],["","59310058020","PROAIR RESPI","AER ","1","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","15","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00031873912","ROBITUSSIN","LIQ 20-400","200","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","28","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00115180301","HYDROXYZ PAM","CAP 25MG","90","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","12","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","64380078706","BUSPIRONE","TAB 7.5MG","60","Select","Select",""],["","00555902742","JUNEL 1.5\/30","TAB ","84","Select","Select",""],["","50111064701","FLUOXETINE","CAP 10MG","30","Select","Select",""],["","64380078706","BUSPIRONE HCL","7.5 MG","60","Select","Select",""],["","49483070210","FLUOXETINE HCL","20 MG","90","Select","Select",""],["","00115180301","HYDROXYZINE PAMOATE","25 MG","90","Select","Select",""],["","00555902742","JUNEL","1.5-0.03MG","84","Select","Select",""],["","00115180301","HYDROXYZ PAM CAP","25MG","90","Select","Select",""],["","66993001968","ALBUTEROL AER HFA","","18","Select","Select",""],["","00031873912","ROBITUSSIN LIQ","20-400","200","Select","Select",""],["","68180016011","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","63304069205","CLINDAMYCIN CAP","150MG","28","Select","Select",""],["","68462010530","ONDANSETRON TAB","4MG","12","Select","Select",""],["","62175061743","PANTOPRAZOLE TAB","40MG","30","Select","Select",""],["","49483060450","IBUPROFEN TAB","800MG","15","Select","Select",""],["","68180012202","CEPHALEXIN CAP","500MG","14","Select","Select",""],["","49483070110","FLUOXETINE CAP","10MG","30","Select","Select",""],["","64380078706","BUSPIRONE TAB","7.5MG","60","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":""}]}]}