{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HTAK   AIRAMSEDOHR ENIRE","gend":1,"add":"ALTA 213EVA CITN","city":"VIRGINIA BEACH","state":"VA","zip":"23451-9998","dob":"1979-03-22","age":"","mstatus":"","insh":"0326110*11","cliId":"","pno":"12\/7570647-4","cno":"","email":"","ename":"","eno":"","pphy":"LIPPS, BRIAN J MD","ppno":"757\/536-2246","pcpadd":"2901 S LYNNHAVEN ROAD SUITE 450","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23452,"pcpcounty":"","pcpid":"","pcpname":"Bayview Hospitalist","plan":"OHP","program":"ACA","lob":"Individual","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E55.9","E28.2","D64.9","I10.","Z72.0","D50.0","E66.01","Z68.45","I89.0","M54.5","I51.89","R06.00","G89.29","R53.83","F17.210","Z13.29","F41.1","Z13.1","Z83.49","N30.00","Z00.01","S70.311A","L08.9","Z23.","R06.02","R07.1","R73.9","Z13.6","I49.1","I49.3","R00.2","R93.49","R06.83","L03.115","Z83.3","J18.9","R60.0","R42.","M79.676","R60.9","R26.2","L60.8","M62.81","L85.3","I51.7"],"date":["2021-08-13","2021-08-13","2019-09-14","2021-08-13","2019-12-28","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2019-09-14","2019-09-14","2019-09-14","2019-09-14","2019-09-14","2019-09-14","2020-08-05","2021-05-11","2019-03-03","2019-03-03","2021-09-30","2020-03-10","2020-03-10","2020-09-22","2020-09-22","2021-06-15","2021-06-15","2021-07-08","2021-06-15","2021-07-08","2019-03-09","2019-03-09","2020-02-15","2020-03-07","2020-09-22","2021-03-02","2021-03-02","2021-03-02","2021-03-02","2021-03-02","2021-03-02","2020-09-30"],"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":[["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","00069047103","CHANTIX","PAK 0.5& 1MG","53","Select","Select",""],["","00527163210","TRIAMT\/HCTZ","CAP 37.5-25","90","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","68382075810","METFORMIN","TAB 500MG","60","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","00591544310","PREDNISONE","TAB 20MG","21","Select","Select",""],["","43547040011","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","47781030601","NITROFUR","CAP 25MG","10","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","59779050156","BACITRACIN","OIN 500\/GM","28","Select","Select",""],["","65162044110","MECLIZINE","TAB 12.5MG","50","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","51267089099","CONTRAVE","TAB 8-90MG","60","Select","Select",""],["","68382002310","ATENOLOL","TAB 50MG","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":""}]}]}