{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DENISE  G NAPLE-INNES","gend":1,"add":"1326 ENGLAND VALLEY ROAD","city":"DUFFIELD","state":"VA","zip":"24244-9998","dob":"1973-05-26","age":"","mstatus":"","insh":"2419278*01","cliId":"","pno":5185385279,"cno":5185385279,"email":"","ename":"","eno":"","pphy":"SERGENT, BERNIE N DO","ppno":2766798890,"pcpadd":"1490 PARK AVE NW SUITE 3","pcpcity":"NORTON","pcpstate":"VA","pcpzip":"24273-9998","pcpcounty":"","pcpid":"","pcpname":"Residency Clinic","plan":"OHP","program":"MEDICAID","lob":"M4","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2764391485,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R10.31","R09.02","Z20.822","J98.4","R06.09","G47.33","G47.10","G47.9","R06.83","R53.83","I50.9","I10.","N39.41","N81.84","J96.01","J44.1","J96.02","S30.1XXA","R74.01","J96.10","Z99.81","I16.0","N39.0","R93.89","G47.36","I50.32","R40.0","F33.9","R65.10","Z68.43","E78.2","I11.0","J44.9","R32.","K76.0","E66.01","Z79.899","Z88.6","K52.9","F17.210","V58.69","K59.00","Z91.14","Z91.128","Z98.890","Z71.6","I07.1","R06.00","H90.3","H81.13","E78.5","M79.81","I27.0"],"date":["2022-03-24","2023-01-12","2023-02-07","2022-11-04","2022-11-04","2023-02-09","2023-01-04","2023-01-16","2023-01-12","2023-01-04","2023-02-11","2023-02-11","2023-04-03","2023-04-03","2022-04-19","2022-04-19","2022-04-19","2023-02-11","2023-02-09","2023-02-11","2023-02-09","2022-03-26","2022-03-26","2022-06-22","2023-01-12","2023-02-07","2022-12-27","2023-02-11","2023-02-07","2023-02-11","2023-02-11","2023-02-07","2023-02-09","2023-02-07","2023-02-07","2023-02-11","2023-02-07","2023-02-07","2022-03-24","2022-03-24","2022-03-24","2022-03-24","2022-03-24","2022-03-24","2022-03-24","2022-03-24","2022-08-16","2022-08-31","2022-10-20","2022-11-08","2023-02-09","2023-02-06","2022-08-31"],"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":[["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","68180097903","LISINOPRIL","TAB 40MG","30","Select","Select",""],["","68382003516","VENLAFAXINE","CAP 75MG ER","60","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","47335075649","IPRATROPIUM\/","SOL ALBUTER","90","Select","Select",""],["","68180071909","AMLODIPINE","TAB 2.5MG","30","Select","Select",""],["","51267089099","CONTRAVE","TAB 8-90MG","120","Select","Select",""],["","00469260130","MYRBETRIQ","TAB 25MG","30","Select","Select",""],["","70377002811","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","57664050658","METOPROL TAR","TAB 25MG","60","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","60","Select","Select",""],["","45802043321","DEXTROMETHORPHAN POLISTIREX","30 MG\/5 ML","89","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":""}]}]}