{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"THOMAS  M NAPIER","gend":0,"add":"4708 RETREAT LN APT 389","city":"FREDERICKSBURG","state":"VA","zip":"22408-9998","dob":"1993-12-16","age":"","mstatus":"","insh":"2151115*01","cliId":"","pno":7575003116,"cno":7575003116,"email":"","ename":"","eno":"","pphy":"COOK, PATRICIA MD","ppno":8044435378,"pcpadd":"1362 TAPPAHANNOCK BLVD","pcpcity":"TAPPAHANNOCK","pcpstate":"VA","pcpzip":"22560-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8044439667,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["B20.","L70.0","L73.9","N28.89","F41.1","F69.","Z04.6","J01.90","L85.3","S05.01XA","X58.XXXA","Y92.89","Y93.89","Z13.30","F17.210","Z21.","Z83.3","Z82.49","Z03.818","Z20.822","L02.01","E86.0","F43.0","F17.200","R30.0","L81.0","Z01.818","C64.1","H93.90","C64.9","N48.9","Z79.899","Z91.013","Z88.8","E55.9","Z53.20","Z02.0","R03.0","R63.4","Z01.812"],"date":["2023-03-28","2023-01-27","2023-01-27","2022-06-14","2022-03-01","2022-07-03","2022-07-03","2022-12-02","2022-12-02","2022-10-01","2022-10-01","2022-10-01","2022-10-01","2022-07-03","2022-07-03","2022-07-03","2022-07-03","2022-07-03","2021-07-07","2021-07-07","2021-11-08","2022-01-24","2022-01-24","2022-06-14","2022-01-24","2022-04-27","2022-08-31","2022-09-07","2022-09-23","2023-03-28","2021-07-08","2022-06-14","2022-06-14","2022-06-14","2022-08-09","2022-08-09","2022-08-09","2022-08-09","2023-02-27","2022-06-06"],"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":[["","61958190101","GENVOYA","150-200-10","30","Select","Select",""],["","42858086706","DRONABINOL","CAP 2.5MG","60","Select","Select",""],["","21922000201","CLINDAMYCIN","SOL 0.01","60","Select","Select",""],["","67405082505","BENZOYL PER","LIQ 5% WASH","148","Select","Select",""],["","65862044930","VALACYCLOVIR","TAB 1GM","14","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","14","Select","Select",""],["","59267100001","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","42806031250","DOXYCYCL HYC","TAB 100MG","14","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","70000004302","ADAPALENE","GEL 0.001","45","Select","Select",""],["","16714020030","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","00299492030","DIFFERIN","GEL 0.001","45","Select","Select",""],["","50383085924","MEGESTROL AC","SUS 40MG\/ML","600","Select","Select",""],["","31604002675","D3","CAP 1000UNIT","60","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","40985027415","D3-1000","CAP 1000UNIT","60","Select","Select",""],["","65162027250","SMZ\/TMP DS","TAB 800-160","14","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","31722094901","OXYCOD\/APAP","TAB 5-325MG","20","Select","Select",""],["","45802000403","HYDROCORT","CRE 0.025","28","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","10","Select","Select",""],["","65862064290","AZITHROMYCIN","TAB 500MG","5","Select","Select",""],["","24208031510","POLYMYXIN B\/","SOL TRIMETHP","10","Select","Select",""],["","72140011047","AQUAPHOR","OIN ADVANCED","10","Select","Select",""],["","00555060602","MEGESTROL ACETATE","20 MG","30","Select","Select",""],["","00054001925","PREDNISONE","50 MG","3","Select","Select",""],["","49035090112","ALLERGY RELIEF","25 MG","2","Select","Select",""],["","21922000201","CLINDAMYCIN PHOSPHATE","1 %","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":""}]}]}