{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"L CIRESSOR ","gend":0,"add":"C REVIR007DAOR KEER","city":"Chesapeake","state":"VA","zip":"23320-6238","dob":"1977-07-06","age":"","mstatus":"","insh":"10119047","cliId":"","pno":"0975732507","cno":7579070183,"email":"","ename":"","eno":"","pphy":"ZATTAM MUSSELMANI MD","ppno":7575433557,"pcpadd":"1422 POINDEXTER ST,","pcpcity":"Chesapeake","pcpstate":"VA","pcpzip":"23324-2431","pcpcounty":"","pcpid":"","pcpname":"MUSSELMANI INTERNAL MEDICINE PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"APT 1D","add3":"","madd1":"700RIVER CREEK ROAD","madd2":"APT 1D","madd3":"","mcity":"Chesapeake","mstate":"VA","mzip":"23320-6238","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M79.89","F20.9","N18.6","R10.2","E11.40","F25.0","F20.0","F25.1","R07.9","I10","F17.200","F31.9","Z68.42","F43.10","F17.210","Z11.52","T18.4XXA","Z68.41","R45.851","F41.9","E66.01","E11.22","G47.00","I12.9","N18.31","Z79.84","Z79.899","Z81.8","Z88.8","F25.9","R45.850","Z20.822","F29","R41.82","R07.89","E11.42","F22","N18.1","E66.9","I20.0","Z74.3","E11.9","F31.81","R00.2","R00.0","Z82.49","Z83.3","S93.401A","R05.9","M79.671","X58.XXXA","Z79.83","F30.9","R03.0","Z04.9","F31.2","F23","F48.9","F99","R20.2","R09.89","Z86.59","Z72.820","M25.571","Z68.37","F32.A","Z02.2","R73.03","R53.81","Z76.0","N18.9","E78.00","Z59.00","F41.8","G47.9","F39","Z68.44","M25.551","E78.5","N17.9","T42.6X6A","G25.1","T43.3X5A","Z53.20","Z76.89","R30.9","Z11.3","E55.9","E11.21","H10.9","T18.9XXA","Z59.89","Z82.5","Z51.89","Z98.890","F30.10","R44.0","R53.1","F60.0","N18.2","J45.909","F33.1","S92.354D","M70.21","M25.421","Z71.2","D64.9","R42","N28.9","R73.09","S92.354A","Z91.14","R46.89","Z01.89","Z56.0","I95.9","R29.818","B35.1","Z03.818","W22.09XA","F31.32","Z76.5","F03.90","S99.911A","Z00.00","G62.9","R44.3","R45.5","E86.0","Z68.43","S92.351K","M79.604","M79.605","R63.8","S92.351A","F09","R07.1","M16.11","I49.8","J39.9","I15.9","F43.21","Z13.39","E11.8","Z23","Z91.51","R45.87","X50.1XXA","Y93.41","R44.1","R69","R06.02","M79.643","M79.672","R55","F32.9","R25.1","T50.916A","T43.596A","Z91.19","Z53.29","Z00.8","H10.31","Z81.1","Z81.4","Z71.3","E66.3","Z71.89","T38.3X6A","T50.906A","L60.3","B35.3","M24.572","M24.571","I49.9","T46.4X6A","R10.30","D72.829","Z68.35","Z59.01","M19.071","M77.31","M77.8","N18.30","T81.49XA","B95.62","H10.10","M54.50","Z62.819","M79.674","Y92.239","Y99.8","Z91.52","R46.2","R45.81","Z91.138","Z53.21","Z68.39","Z79.1","M25.521","K59.00","Z91.048","E11.65","R50.9","R05.1","J06.9","F60.9","M19.021","M25.552","A41.9","Y92.009","T46.5X6A","F03.92","N48.89","S01.01XA","W18.39XA","Y93.89","Y92.098","F20.1","R10.84","L03.116","T76.21XA","F43.0","M79.641","M79.642","M72.2","Z88.1","F51.05","L84","Z91.148","R51.9","M79.10","Z13.9","R20.8","F43.9","M79.606","S99.929A","M25.541","M25.542","F60.81","R22.41","Z68.31","G89.11","R45.89","Z77.21"],"date":["2023-06-02","2023-06-14","2022-06-10","2022-06-10","2023-04-30","2023-06-22","2022-09-09","2022-08-21","2022-05-21","2023-05-03","2022-08-02","2023-06-14","2022-06-21","2022-09-17","2023-06-12","2022-01-21","2021-12-21","2023-06-08","2023-06-14","2023-05-21","2023-06-12","2023-06-12","2023-05-06","2023-06-12","2023-06-08","2023-06-08","2023-06-12","2023-06-07","2023-06-07","2023-04-30","2023-06-04","2023-06-12","2023-06-05","2023-02-18","2022-05-20","2023-06-12","2023-06-14","2023-06-12","2023-02-13","2022-05-20","2022-05-20","2023-02-24","2022-06-21","2021-12-29","2022-06-01","2023-06-12","2022-10-15","2022-09-30","2023-02-18","2023-06-02","2022-09-30","2022-09-30","2022-09-26","2022-01-02","2022-06-04","2023-06-05","2023-02-18","2022-10-04","2022-06-21","2023-04-27","2021-12-10","2022-09-05","2021-10-25","2022-09-03","2023-06-05","2023-02-15","2023-06-08","2023-02-15","2021-12-22","2023-02-05","2023-02-22","2021-11-15","2023-06-07","2023-02-13","2021-12-22","2023-02-19","2021-10-28","2021-12-29","2022-07-21","2021-12-07","2021-12-31","2021-04-07","2021-04-07","2021-04-07","2021-02-04","2021-02-04","2021-11-15","2022-02-09","2022-06-24","2022-06-24","2021-12-21","2022-10-15","2022-10-15","2022-05-09","2023-06-02","2021-12-21","2023-04-30","2022-05-16","2022-01-08","2022-10-02","2022-08-10","2022-01-26","2022-09-01","2023-02-10","2023-02-20","2022-07-02","2022-09-01","2022-05-08","2022-05-08","2021-05-28","2022-09-14","2023-06-14","2023-06-14","2021-11-10","2023-02-07","2022-10-09","2022-05-09","2022-09-09","2022-09-09","2022-09-09","2022-01-14","2023-02-22","2022-07-23","2022-09-03","2023-06-11","2023-04-27","2023-04-30","2021-07-02","2021-09-30","2021-07-02","2022-11-21","2021-12-22","2021-12-22","2021-12-22","2022-11-21","2021-11-14","2021-11-10","2021-12-30","2022-02-05","2022-08-09","2022-04-28","2022-05-18","2021-11-15","2022-04-13","2021-11-15","2022-09-27","2022-09-27","2022-08-04","2022-08-04","2023-02-05","2022-05-17","2021-12-16","2022-08-15","2023-06-02","2022-05-08","2023-02-13","2022-09-17","2021-12-31","2021-12-31","2021-12-31","2023-04-30","2022-05-18","2022-07-12","2021-12-18","2021-12-18","2021-03-03","2021-03-17","2021-03-03","2022-10-05","2022-10-05","2021-02-17","2023-05-11","2021-02-17","2021-02-17","2022-04-29","2021-12-12","2022-06-10","2021-03-17","2023-02-22","2022-10-03","2022-11-21","2022-11-21","2022-11-21","2022-02-09","2022-02-09","2022-02-09","2022-02-09","2022-02-09","2022-02-09","2022-09-27","2022-08-01","2022-08-01","2022-08-01","2022-06-05","2021-12-22","2021-12-22","2021-04-27","2023-02-06","2023-06-12","2023-02-20","2023-02-10","2023-06-07","2022-07-21","2023-02-18","2023-02-18","2023-02-18","2022-09-28","2023-02-21","2023-02-22","2023-02-21","2023-02-05","2023-02-05","2023-02-05","2023-02-11","2023-04-12","2023-04-12","2023-04-12","2023-04-12","2023-04-12","2023-05-06","2023-05-06","2023-03-20","2023-05-21","2023-05-03","2023-05-03","2023-05-04","2023-02-11","2023-05-01","2023-05-11","2023-05-01","2023-05-26","2023-05-26","2023-04-30","2023-05-26","2023-05-21","2023-06-02","2023-06-02","2023-05-03","2023-05-03","2023-06-08","2023-06-02","2023-02-13","2023-05-26","2023-06-05","2023-03-20"],"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":[["","31722070190","LOSARTAN POT","TAB 50MG","90","Select","Select",""],["","65162028103","PALIPERIDONE","TAB ER 3MG","30","Select","Select",""],["","68180098201","LISINOPRIL","TAB 30MG","30","Select","Select",""],["","69315013710","BENZTROPINE","TAB 1MG","60","Select","Select",""],["","62756079888","DIVALPROEX","TAB 500MG DR","60","Select","Select",""],["","65162018910","NAPROXEN","TAB 375MG","14","Select","Select",""],["","50111045001","TRAZODONE","TAB 150MG","30","Select","Select",""],["","59762015601","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","00378240501","TRIFLUOPERAZ","TAB 5MG","30","Select","Select",""],["","50458056301","INVEGA SUST","INJ 156MG\/ML","1","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","6","Select","Select",""],["","14539067501","HYDROXYZ PAM","CAP 50MG","120","Select","Select",""],["","55111016730","OLANZAPINE","TAB 15MG","30","Select","Select",""],["","68180051801","LISINOP\/HCTZ","TAB 10-12.5","30","Select","Select",""],["","68382011505","RISPERIDONE","TAB 2MG","60","Select","Select",""],["","67877056110","METFORMIN","TAB 500MG","30","Select","Select",""],["","51991029401","OXCARBAZEPIN","TAB 600MG","60","Select","Select",""],["","43547030703","ARIPIPRAZOLE","TAB 30MG","30","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","69097073102","TERBINAFINE","TAB 250MG","14","Select","Select",""],["","75834022101","CARBAMAZEPIN","TAB 200MG","60","Select","Select",""],["","47335075649","IPRATROPIUM\/","SOL ALBUTER","180","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","68382050010","OMEPRAZOLE","CAP 40MG","7","Select","Select",""],["","00603548232","PROPRANOLOL","TAB 10MG","60","Select","Select",""],["","00527179001","FLUPHENAZINE","TAB 5MG","1","Select","Select",""],["","69097083305","SERTRALINE","TAB 25MG","30","Select","Select",""],["","64380076111","OMEGA-3-ACID","CAP 1GM","30","Select","Select",""],["","00832030300","CHLORPROMAZ","TAB 100MG","1","Select","Select",""],["","00904600961","LORAZEPAM","TAB 2MG","1","Select","Select",""],["","43598084858","ZIPRASIDONE","INJ 20MG","1","Select","Select",""],["","45802046564","KETOCONAZOLE","SHA 0.02","120","Select","Select",""],["","00904585361","IBUPROFEN","TAB 400MG","10","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","57237000201","HYDROCHLOROT","CAP 12.5MG","13","Select","Select",""],["","31722070430","VALACYCLOVIR","TAB 500MG","10","Select","Select",""],["","50458030611","RISPERDAL","INJ 25MG","1","Select","Select",""],["","45802013835","CICLOPIROX","CRE 0.0077","30","Select","Select",""],["","31722070190","LOSARTAN","TAB 50MG","90","Select","Select",""],["","50458056301","INVEGA","INJ 156MG\/ML","1","Select","Select",""],["","14539067501","HYDROXYZ","CAP 50MG","120","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","63402030430","LATUDA","TAB 40MG","5","Select","Select",""],["","43547040611","CLONAZEPAM","TAB 0.5MG","6","Select","Select",""],["","31722070190","LOSARTAN POT TAB","50MG","90","Select","Select",""],["","65162028103","PALIPERIDONE TAB ER","3MG","30","Select","Select",""],["","68180098201","LISINOPRIL TAB","30MG","30","Select","Select",""],["","69315013710","BENZTROPINE TAB","1MG","60","Select","Select",""],["","62756079888","DIVALPROEX TAB","500MG DR","60","Select","Select",""],["","65162018910","NAPROXEN TAB","375MG","14","Select","Select",""],["","50111045001","TRAZODONE TAB","150MG","30","Select","Select",""],["","59762015601","ATORVASTATIN TAB","20MG","30","Select","Select",""],["","00378240501","TRIFLUOPERAZ TAB","5MG","30","Select","Select",""],["","50458056301","INVEGA SUST INJ","156MG\/ML","1","Select","Select",""],["","70010075401","METHOCARBAM TAB","500MG","6","Select","Select",""],["","14539067501","HYDROXYZ PAM CAP","50MG","120","Select","Select",""],["","55111016730","OLANZAPINE TAB","15MG","30","Select","Select",""],["","68180051801","LISINOP\/HCTZ TAB","10-12.5","30","Select","Select",""],["","68382011505","RISPERIDONE TAB","2MG","60","Select","Select",""],["","67877056110","METFORMIN TAB","500MG","30","Select","Select",""],["","51991029401","OXCARBAZEPIN TAB","600MG","60","Select","Select",""],["","43547030703","ARIPIPRAZOLE TAB","30MG","30","Select","Select",""],["","68180072103","AMLODIPINE TAB","10MG","30","Select","Select",""],["","69097073102","TERBINAFINE TAB","250MG","14","Select","Select",""],["","75834022101","CARBAMAZEPIN TAB","200MG","60","Select","Select",""],["","47335075649","IPRATROPIUM\/ SOL ALBUTER","","180","Select","Select",""],["","65862042005","SMZ\/TMP DS TAB","800-160","20","Select","Select",""],["","00832030300","CHLORPROMAZ TAB","100MG","1","Select","Select",""],["","63402030430","LATUDA TAB","40MG","5","Select","Select",""],["","00904585361","IBUPROFEN TAB","400MG","10","Select","Select",""],["","00904600961","LORAZEPAM TAB","2MG","1","Select","Select",""],["","00527179001","FLUPHENAZINE TAB","5MG","1","Select","Select",""],["","43547040611","CLONAZEPAM TAB","0.5MG","6","Select","Select",""],["","57237000201","HYDROCHLOROT CAP","12.5MG","13","Select","Select",""],["","68382050010","OMEPRAZOLE CAP","40MG","7","Select","Select",""],["","00603548232","PROPRANOLOL TAB","10MG","60","Select","Select",""],["","69097083305","SERTRALINE TAB","25MG","30","Select","Select",""],["","64380076111","OMEGA-","3-ACID CAP 1GM","30","Select","Select",""],["","43598084858","ZIPRASIDONE INJ","20MG","1","Select","Select",""],["","00781315972","OLANZAPINE INJ","10MG","2","Select","Select",""],["","45802046564","KETOCONAZOLE SHA","2%","120","Select","Select",""],["","65162083366","DICLOFENAC GEL","1%","100","Select","Select",""],["","31722070430","VALACYCLOVIR TAB","500MG","10","Select","Select",""],["","50458030611","RISPERDAL INJ","25MG","1","Select","Select",""],["","45802013835","CICLOPIROX CRE","0.77%","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":""}]}]}