{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ASHLEY BLAND","gend":1,"add":"3004 WHITEMARSH ROAD","city":"SUFFOLK","state":"VA","zip":"23434-9998","dob":"1984-10-03","age":"","mstatus":"","insh":"8937346*01","cliId":"","pno":7578094436,"cno":7578094436,"email":"","ename":"","eno":"","pphy":"WOOD, SABRINA D NP","ppno":7578272115,"pcpadd":"4001 COLISEUM DR STE 310","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":"23666-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7575109383,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E10.65","E10.9","Z79.4","E10.10","N17.0","E03.9","J45.909","NO DATA","G40.909","Z96.41","I95.9","E83.51","E78.2","E86.1","F17.210","E86.0","K21.9","Z88.2","Z28.310","Z53.29","D72.829","E87.2","R57.9","R79.89","I10.","E87.8","R11.2","R57.1","E27.40","E10.3293","E03.8","E06.3","E78.5","E10.69","M79.672","S92.902A","E10.8","S93.622A","S92.355A","E10.40","E10.649","A41.9"],"date":["2023-05-17","2022-11-29","2022-11-29","2022-07-10","2022-07-10","2022-07-10","2022-07-07","2022-07-07","2022-07-07","2022-07-07","2022-07-07","2022-07-10","2022-07-10","2022-07-07","2022-07-07","2022-07-10","2022-07-07","2022-07-07","2022-07-07","2022-07-07","2022-07-07","2022-07-07","2022-07-09","2022-07-10","2022-07-10","2022-07-10","2022-07-10","2022-07-10","2022-07-10","2022-12-13","2021-05-20","2021-05-20","2021-05-20","2021-05-20","2023-01-03","2023-01-03","2023-05-17","2023-02-03","2023-01-10","2023-05-17","2023-05-17","2022-07-08"],"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":[["","00527496032","LEVOTHYROXIN","CAP 150MCG","30","Select","Select",""],["","68180063609","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","65702071210","ACCU-CHEK","TES GUIDE","200","Select","Select",""],["","65862037401","ESCITALOPRAM","TAB 10MG","90","Select","Select",""],["","00002751659","HUMALOG","100\/ML","15","Select","Select",""],["","08489830910","PEN NEEDLES","MIS 31GX8MM","100","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","6","Select","Select",""],["","00002879959","HUMALOG KWIK","INJ 100\/ML","3","Select","Select",""],["","00245021311","MIDODRINE","TAB 10MG","90","Select","Select",""],["","65702071110","ACCU-CHEK GUIDE TEST STRIP","","450","Select","Select",""],["","65702028810","ACCU-CHEK FASTCLIX LANCET DRUM","","510","Select","Select",""],["","62088000031","INPEN (FOR HUMALOG)","","1","Select","Select",""],["","56151060150","TRUEPLUS KETONE TEST STRIP","","50","Select","Select",""],["","72065012112","GVOKE HYPOPEN","2-PACK 1 MG\/0.2ML","0.4","Select","Select",""],["","63000033698","GUARDIAN SENSOR","3","5","Select","Select",""],["","00074706990","SYNTHROID","150 MCG","90","Select","Select",""],["","05244001887","MINIMED MIO ADVANCE","","10","Select","Select",""],["","70377000712","ROSUVASTATIN CALCIUM","10 MG","90","Select","Select",""],["","76300033210","PARADIGM","","10","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":""}]}]}