{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KEITH BANAAG","gend":0,"add":"1869 DOLINA DR","city":"VIRGINIA BEACH","state":"VA","zip":"23453","dob":"1960-01-04","age":"","mstatus":"","insh":"2438064*01","cliId":"","pno":7577545985,"cno":7577545985,"email":"","ename":"","eno":"","pphy":"MITCHELL, MEGAN B NP","ppno":7573123132,"pcpadd":"736 BATTLEFIELD BLVD N","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":"23320-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7573126184,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z51.5","C34.90","G93.89","G93.41","E43.","NO DATA","F41.9","Z66.","Z51.0","C34.11","C79.31","C79.51","J98.2","J18.9","J44.0","J44.1","G89.3","I25.10","E11.9","J70.1","I25.2","Z46.6","Z51.12","D17.1","M85.80","R53.1","R06.02","J44.9","C71.9","R62.7","E27.49","Z91.81","R53.82","G89.29","I48.91","C34.01","G93.40","R59.0","G93.6","G93.5","I61.1","C34.91","R64.","G93.9","I48.0","F41.8","M62.830","R46.2","R41.82","Z20.822","I13.0","I50.9"],"date":["2023-01-24","2023-01-26","2022-11-23","2022-11-23","2023-02-09","2023-01-04","2023-01-24","2022-11-23","2022-11-28","2023-04-12","2023-02-09","2023-04-05","2023-02-09","2023-02-09","2023-02-09","2023-02-09","2023-02-09","2023-01-04","2023-01-04","2023-02-09","2023-01-04","2023-01-04","2023-04-12","2022-07-25","2023-04-05","2022-11-15","2023-01-26","2023-01-26","2023-01-26","2023-01-26","2023-03-08","2023-02-09","2023-04-05","2022-11-17","2022-11-23","2022-11-23","2022-11-23","2022-03-07","2022-11-16","2022-11-16","2022-11-16","2022-11-22","2022-11-16","2022-11-16","2023-01-24","2022-04-12","2022-04-12","2022-11-16","2022-11-16","2022-11-16","2022-11-22","2022-11-22"],"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":[["","65862073260","AMIODARONE","TAB 200MG","30","Select","Select",""],["","68001015303","CARVEDILOL","TAB 3.125MG","180","Select","Select",""],["","68001041306","DULOXETINE","CAP 20MG","30","Select","Select",""],["","00904585360","IBUPROFEN","TAB 400MG","120","Select","Select",""],["","16729022516","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","60","Select","Select",""],["","68462086101","CHLORPROMAZ","TAB 10MG","20","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","60","Select","Select",""],["","68001024617","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","60505132501","MIDODRINE","TAB 10MG","90","Select","Select",""],["","00254101196","SUCRALFATE","SUS 1GM\/10ML","1200","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","90","Select","Select",""],["","0","COMPOUND"," ","300","Select","Select",""],["","00228202710","ALPRAZOLAM","TAB 0.25MG","6","Select","Select",""],["","65862050301","AMOX\/K CLAV","TAB 875-125","11","Select","Select",""],["","64380097106","HYDROCORT","TAB 10MG","60","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","42","Select","Select",""],["","57664022388","OXYCODONE","TAB 5MG","12","Select","Select",""],["","65862056090","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","68001040506","LEVETIRACETA","TAB 1000MG","60","Select","Select",""],["","65628005001","FIRST-MOUTHW","SUS BLM","237","Select","Select",""],["","68001040307","LEVETIRACETAM","500 MG","60","Select","Select",""],["","65162010210","GABAPENTIN","300 MG","60","Select","Select",""],["","00003089421","ELIQUIS","5 MG","60","Select","Select",""],["","60505132501","MIDODRINE HCL","10 MG","60","Select","Select",""],["","00093506101","HYDROXYZINE HCL","25 MG","30","Select","Select",""],["","65862056090","PANTOPRAZOLE SODIUM","40 MG","30","Select","Select",""],["","00406012301","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","42","Select","Select",""],["","42543097106","HYDROCORTISONE","10 MG","60","Select","Select",""],["","00527328446","LEVOTHYROXINE SODIUM","100 MCG","30","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":""}]}]}