{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RYAN BRANCH","gend":0,"add":"700 SAINT MATTHEWS SQ APT 2","city":"VIRGINIA BEACH","state":"VA","zip":"23454-9998","dob":"1988-03-03","age":"","mstatus":"","insh":"2485861*01","cliId":"","pno":7572390080,"cno":7572390080,"email":"","ename":"","eno":"","pphy":"KUBICKI, TED M MD","ppno":7573952500,"pcpadd":"1024 FIRST COLONIAL RD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23454-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - First Colonial","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7572759700,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K85.20","NO DATA","F10.231","I42.9","E83.51","K70.30","I10.","E66.9","Z86.74","E83.42","M10.9","E86.0","E87.6","K76.0","R05.9","R50.9","G93.40","R45.1","G93.1","R41.89","V58.89","M62.81","R26.9","R13.12","F10.10","R56.9","U07.1","K85.90","F10.239","Z86.16","R41.0","J96.01","K86.0","J96.91","I11.0","I50.20","I82.402","D64.9","R13.10","F41.1","F17.210","Z79.01","Z20.822","G93.41","I50.21","E87.2","R94.31","A41.9","I47.2","R65.20","Z00.00","F10.20","T59.891A","K86.1","R11.2","I77.810","L81.9","J15.212","D69.6","R00.0"],"date":["2023-04-20","2023-04-26","2023-02-03","2023-01-23","2023-01-23","2023-01-23","2023-04-09","2023-01-23","2023-02-01","2023-02-03","2023-01-23","2023-01-23","2023-02-02","2023-01-23","2023-01-23","2023-01-30","2023-02-03","2022-07-06","2022-07-06","2022-07-06","2022-07-06","2022-07-06","2022-07-06","2022-07-06","2022-11-29","2023-04-26","2022-08-12","2023-02-01","2023-02-02","2023-02-01","2023-02-03","2023-04-26","2023-02-02","2022-08-12","2022-08-12","2022-08-12","2022-08-12","2022-08-12","2022-08-12","2022-08-12","2022-08-12","2022-08-12","2022-07-06","2022-07-06","2022-07-06","2022-07-06","2022-07-06","2022-07-06","2022-07-06","2022-07-06","2022-08-30","2022-08-30","2023-01-30","2023-02-23","2023-02-23","2023-02-01","2022-10-20","2023-04-26","2023-04-09","2023-04-09"],"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":[["","00536120215","LIDOCAINE PA","PAD 0.04","7","Select","Select",""],["","31722054201","INDOMETHACIN","CAP 25MG","30","Select","Select",""],["","00527512570","LACTULOSE","SOL 10GM\/15","473","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","59651000305","OMEPRAZOLE","40 MG","30","Select","Select",""],["","69315012710","FOLIC ACID","1 MG","90","Select","Select",""],["","80681009800","VITAMIN B-1","TAB 100MG","30","Select","Select",""],["","10006073021","VITAMIN B1","TAB 100MG","30","Select","Select",""],["","50742026001","NIFEDIPINE ER","30 MG","30","Select","Select",""],["","50428048545","B-","1 100 MG","30","Select","Select",""],["","65162019050","NAPROXEN","500 MG","10","Select","Select",""],["","40985022368","THERAPEUTIC-M","9MG-400MCG","30","Select","Select",""],["","65862085901","FAMOTIDINE","20 MG","28","Select","Select",""],["","76385011350","CARVEDILOL","25 MG","30","Select","Select",""],["","33342006707","OLANZAPINE","2.5 MG","15","Select","Select",""],["","49884017101","COLCHICINE","0.6 MG","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":""}]}]}