{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JACQUELYN COLEMAN","gend":1,"add":"1769 ACORN ST","city":"CHESAPEAKE","state":"VA","zip":"23324-9998","dob":"1983-07-07","age":"","mstatus":"","insh":"2320347*01","cliId":"","pno":7579075464,"cno":7579075464,"email":"","ename":"","eno":"","pphy":"MARKOVIC, VLADIMIR MD","ppno":7575339108,"pcpadd":"155 KINGSLEY LANE SUITE 320,","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":"23505-9998","pcpcounty":"","pcpid":"","pcpname":"Hampton Roads Community Health Center","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"1179 LIBERTYVILLE ROAD","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7576226384,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","I42.0","M25.461","M25.561","M54.9","J30.1","M75.51","M25.511","M17.0","G89.29","Z68.41","R07.89","R42.","I50.9","Z71.6","F41.8","Z68.42","G47.33","E66.01","W19.XXXA","M25.661","M21.161","M25.662","J32.9","J34.2","J34.3","R90.89","S89.91XA","NO DATA","J30.2","M70.62","M16.12","M25.752","R07.9","R06.83","G47.30","J32.8"],"date":["2022-08-26","2021-10-05","2022-10-11","2022-10-18","2022-10-11","2023-02-27","2021-11-15","2021-11-15","2022-10-18","2022-10-18","2023-04-14","2021-12-08","2021-12-08","2021-06-09","2021-06-09","2022-02-08","2021-06-09","2022-01-18","2023-04-14","2022-10-18","2022-10-18","2022-10-18","2022-10-18","2022-11-02","2022-05-05","2022-05-05","2022-07-06","2022-10-11","2022-10-11","2023-02-22","2023-04-14","2023-04-14","2023-04-14","2021-12-08","2022-01-18","2021-11-16","2023-02-22"],"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":[["","65862050320","AMOX\/K CLAV TAB","875-125","20","Select","Select",""],["","00054327099","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","68180072103","AMLODIPINE TAB","10MG","90","Select","Select",""],["","76385011150","CARVEDILOL TAB","6.25MG","180","Select","Select",""],["","13668010510","ISOSORB MONO TAB","60MG ER","90","Select","Select",""],["","69097083305","SERTRALINE TAB","25MG","90","Select","Select",""],["","68180098103","LISINOPRIL TAB","20MG","90","Select","Select",""],["","63304069301","CLINDAMYCIN CAP","300MG","21","Select","Select",""],["","68180012202","CEPHALEXIN CAP","500MG","21","Select","Select",""],["","68462010530","ONDANSETRON TAB","4MG","12","Select","Select",""],["","00378064205","PREDNISONE TAB","20MG","8","Select","Select",""],["","53746010901","HYDROCO\/APAP TAB","5-325MG","50","Select","Select",""],["","59651021430","AZELASTINE SPR","0.1%","30","Select","Select",""],["","00093031401","KETOROLAC TAB","10MG","20","Select","Select",""],["","59779081710","CVS NASAL SPR","0.05%","30","Select","Select",""],["","50428058168","NASAL WASH PAK","2300-700","60","Select","Select",""],["","50428031180","SALINE NASAL SPR","0.65%","44","Select","Select",""],["","65162018910","NAPROXEN TAB","375MG","14","Select","Select",""],["","67877054360","CEFDINIR CAP","300MG","14","Select","Select",""],["","00093342210","CYCLOBENZAPR TAB","10MG","15","Select","Select",""],["","00603188016","LIDOCAINE PAD","5%","15","Select","Select",""],["","68180098103","LISINOPRIL","20 MG","90","Select","Select",""],["","49483060450","IBUPROFEN","800 MG","30","Select","Select",""],["","68180072103","AMLODIPINE BESYLATE","10 MG","90","Select","Select",""],["","67877021660","CEFUROXIME","500 MG","20","Select","Select",""],["","00603533815","PREDNISONE","10 MG","21","Select","Select",""],["","43547040111","FUROSEMIDE","20 MG","30","Select","Select",""],["","13668010510","ISOSORBIDE MONONITRATE ER","60 MG","90","Select","Select",""],["","00536100901","FERROUS SULFATE","325(65) MG","30","Select","Select",""],["","00093310905","AMOXICILLIN","500 MG","40","Select","Select",""],["","69097083305","SERTRALINE HCL","25 MG","90","Select","Select",""],["","63304069301","CLINDAMYCIN HCL","300 MG","21","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":""}]}]}