{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TRACY JOHNSON","gend":1,"add":"385 KINSMEN WAY APT 12","city":"HAMPTON","state":"VA","zip":"23666-9998","dob":"1980-05-14","age":"","mstatus":"","insh":"9142584*01","cliId":"","pno":7576077865,"cno":7576077865,"email":"","ename":"","eno":"","pphy":"BICE, HAMILTON L DO","ppno":7573311422,"pcpadd":"216 MASON AVENUE","pcpcity":"CAPE CHARLES","pcpstate":"VA","pcpzip":"23310-9998","pcpcounty":"","pcpid":"","pcpname":"Cape Charles Medical Center","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7573311624,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["U07.1","R50.81","R52.","R53.83","K74.60","Z20.822","M54.5","R17.","N91.2","D69.6","F43.0","V58.69","Z91.14","R94.5","Z20.828","H31.092","H04.123","NO DATA","F10.20","F10.99","R53.81","Z88.8","Z72.89","R51.9","J06.9","Z11.59","K59.00","R60.9","K70.9","F33.1","F41.1","F99.","F10.920","Z63.5","F41.9","D64.9","F10.10","N92.1","R53.1","J40.","R05.","N91.1","N92.0","Z11.3","R82.998","N76.0","B34.9","T50.905A","R42.","R11.0","N30.00","Z03.818","R50.9","F10.239","F33.2","R60.0","E55.9"],"date":["2021-10-04","2021-10-04","2021-10-04","2021-10-04","2021-09-02","2022-11-11","2021-03-30","2021-03-30","2021-03-30","2021-07-27","2021-05-20","2021-05-20","2021-05-20","2021-06-15","2021-06-25","2022-05-12","2022-05-12","2022-11-14","2022-10-25","2022-11-14","2021-07-27","2022-11-11","2021-07-27","2021-07-27","2021-08-16","2021-08-25","2022-11-11","2022-10-19","2022-10-19","2022-11-12","2022-11-11","2022-11-11","2022-11-11","2022-11-11","2022-11-11","2021-05-28","2021-06-02","2021-06-02","2021-06-01","2021-06-07","2021-08-24","2021-05-05","2021-06-10","2022-04-20","2021-05-05","2022-04-20","2021-06-25","2021-06-14","2021-06-14","2021-06-14","2021-07-27","2021-08-16","2021-08-16","2022-10-19","2022-10-19","2022-10-19","2022-10-19"],"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":[["","31604002674","D3","TAB 2000UNIT","60","Select","Select",""],["","11822511210","VITAMIN D-3","CAP 2000UNIT","60","Select","Select",""],["","60219106901","POT CHLORIDE","TAB 20MEQ ER","180","Select","Select",""],["","50383079516","LACTULOSE","SOL 10GM\/15","300","Select","Select",""],["","60505004101","ETODOLAC","TAB 400MG","20","Select","Select",""],["","68462030450","NORETHIN ACE","TAB 5MG","90","Select","Select",""],["","65162027210","SMZ\/TMP DS","TAB 800-160","6","Select","Select",""],["","00555077902","MEDROXYPR AC","TAB 10MG","28","Select","Select",""],["","67877021520","CEFUROXIME","TAB 250MG","20","Select","Select",""],["","70700012285","VOLNEA","TAB ","84","Select","Select",""],["","72647033104","METHYLPRED","TAB 4MG","21","Select","Select",""],["","49483061850","NAPROXEN","TAB 500MG","30","Select","Select",""],["","68382009801","PAROXETINE","TAB 20MG","90","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","00245010810","FERROUS SULF","TAB 325MG EC","90","Select","Select",""],["","68180089173","ENSKYCE","TAB ","28","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","90","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","65162046550","IBUPROFEN","TAB 600MG","15","Select","Select",""],["","45802013970","METRONIDAZOL","GEL 0.75%VAG","70","Select","Select",""],["","80777027399","MODERNA VAC","INJ COVID-19","0","Select","Select",""],["","42571016242","AMOX\/K CLAV","TAB 875-125","20","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":""}]}]}