{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANIRTALRETRAC ","gend":1,"add":"P TS REMRAF7212 XOB O","city":"PETERSBURG","state":"VA","zip":"23804-9998","dob":"1978-12-26","age":"","mstatus":"","insh":"05200210*88","cliId":"","pno":"95\/4085985-0","cno":"804\/225-5364","email":"","ename":"","eno":"","pphy":"GEORGE, LEELAMMA MD","ppno":"804\/526-8640","pcpadd":"215 TEMPLE AVE","pcpcity":"COLONIAL HEIGHTS","pcpstate":"VA","pcpzip":23834,"pcpcounty":"","pcpid":"","pcpname":"LEELAMMA GEORGE MD","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","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":["D64.9","E03.9","R49.0","E83.51","J38.00","J38.2","Z68.42","J38.01","Z68.41","Z20.828","K21.9","E89.0","J44.9","E66.01","Z79.890","Z79.51","Z87.891","Z80.8","M17.11","M25.551","G89.4","R12.","R39.9","I50.9","J30.1","J30.89","C73.","E55.9","R13.12","M77.52","B35.3","B35.1","I73.9","G62.9","M79.673","L70.0","L81.0","L98.8","L90.5","R92.8","N64.4","M16.0","M17.12","M79.7","R20.9","F32.9","E66.9","F41.9","F43.25","J40.","M93.262","M93.261","H10.012","R00.2","R07.89","N89.8","R30.0","Z11.3","Z01.810","Z11.59","L72.8","L73.2","R10.9","M25.651","M70.61","M76.30","R20.8","G47.8","R26.89","R27.9","M62.81","Z73.6","G47.33","F20.9","E78.00","Z85.850","J44.0","N30.01","Z11.1","T78.40XA","D50.9","G56.22","M47.817","M47.812","D16.9","J20.9","R05.","R06.02","D12.3","Z12.11","Z82.49","M54.16","V58.89","Z68.43","Z79.899","M51.26","J31.0","J06.9","M21.6X2","M21.6X1","M79.672","M79.671","M76.31","Z01.812","K59.04","K64.9","R19.8","G57.93","H05.221","L04.9","M19.041","R19.7","R19.4","R14.0","J45.909","M54.9","R94.39","M72.2","Z01.419","R10.2","M16.11","K59.09","R10.13","Z86.010","M26.609","NO DATA","G43.909","H92.01","R07.9","Z12.39","J30.9","M25.512","M75.82","M75.52","M79.644","R22.31","R20.0","M54.17","L02.211","I25.10","R53.1","R26.81","R53.81","K11.8","K59.00","J02.9","R11.0","R09.81","F19.21","M19.90","Z22.322","R51.","M25.542","L60.0","Z88.8","Z88.6","Z91.041","K29.50","G89.29","M62.830","M89.8X1","M54.6","M60.819","R82.90","G56.02","M79.602","M54.12","M79.642","K11.3","K11.23","H04.123","H52.4","H52.03","I31.1","K11.0","M17.0","G50.1","R68.2","F45.8","D22.5","L08.9","R42.","H93.11","R22.0","J01.00","Z98.84","K11.6","R07.0","L02.416","L02.415","L02.411","L02.412","L02.31","K60.3","K61.0","E66.09","Z68.36","Z98.0","R00.1","I31.3","M20.12","M65.30","M62.838","M67.441","M25.521","R10.816","Z47.89","M25.641","M25.421","D72.819","L68.0","R73.9","Z68.39","Z92.3","D24.1","Z68.34","Z68.37","R53.83","J43.9","S83.206A","M70.62"],"date":["2022-04-27","2022-10-19","2022-10-19","2022-01-19","2021-10-20","2022-10-19","2021-08-26","2021-06-10","2022-06-14","2021-08-06","2022-08-08","2022-08-08","2022-10-10","2022-06-14","2022-08-08","2022-08-08","2022-08-08","2021-10-18","2022-11-02","2021-11-18","2022-11-02","2021-10-21","2021-11-10","2021-11-10","2021-08-06","2021-03-24","2022-07-19","2022-01-19","2020-04-03","2021-01-19","2022-09-06","2022-09-06","2022-06-21","2021-03-18","2022-03-15","2022-01-19","2022-01-19","2022-01-19","2022-01-19","2021-06-29","2021-06-29","2021-11-16","2021-12-15","2022-06-14","2021-01-14","2020-09-16","2021-01-14","2020-06-16","2022-08-24","2020-04-11","2020-08-21","2020-08-21","2020-09-01","2020-10-02","2022-05-31","2021-02-11","2020-10-16","2022-02-14","2020-10-26","2020-11-27","2020-12-09","2022-06-14","2021-10-18","2021-11-18","2022-11-22","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2022-05-31","2022-01-19","2020-05-21","2021-07-25","2020-12-19","2021-05-31","2022-04-27","2020-01-08","2022-05-26","2020-01-08","2020-01-08","2020-04-15","2020-04-15","2020-04-15","2020-06-08","2020-06-08","2020-11-06","2022-04-21","2020-12-16","2020-12-04","2021-02-17","2022-04-21","2022-04-20","2021-07-25","2021-08-19","2021-08-19","2022-08-02","2022-10-12","2021-10-11","2020-11-27","2021-04-06","2021-04-06","2021-04-06","2021-05-17","2021-06-02","2021-06-02","2021-07-12","2021-08-31","2021-08-31","2022-07-15","2022-10-10","2020-04-10","2020-11-30","2021-03-02","2022-02-14","2020-02-03","2020-03-06","2020-02-19","2022-08-08","2020-02-19","2020-03-16","2022-10-19","2020-03-16","2020-10-21","2022-05-13","2022-02-14","2021-04-20","2021-08-30","2021-08-30","2021-08-30","2022-03-15","2022-10-10","2020-06-16","2020-06-16","2020-06-23","2020-11-30","2021-10-19","2021-10-19","2021-10-19","2019-09-27","2019-01-28","2019-01-30","2019-01-30","2019-05-04","2019-05-04","2019-05-04","2019-05-04","2019-07-10","2019-07-24","2022-09-06","2019-04-02","2019-04-02","2019-04-02","2019-01-14","2019-01-15","2019-01-15","2019-02-04","2019-02-04","2019-02-04","2019-01-31","2019-08-16","2019-08-16","2019-11-13","2019-09-23","2019-03-11","2019-04-17","2019-03-26","2019-03-26","2019-03-26","2019-03-29","2019-07-10","2019-11-20","2019-02-28","2019-02-28","2019-02-28","2019-06-03","2019-08-05","2019-11-21","2019-11-21","2019-02-22","2019-05-02","2022-08-08","2019-02-22","2019-05-14","2019-08-05","2019-08-05","2019-08-05","2019-08-05","2022-04-15","2022-03-11","2022-03-11","2022-05-31","2022-05-31","2022-08-08","2022-05-03","2022-05-13","2022-08-02","2022-09-13","2022-09-03","2022-10-10","2022-04-21","2022-07-15","2022-10-17","2022-10-17","2022-10-17","2022-04-15","2022-07-19","2022-01-19","2022-01-19","2022-01-19","2022-05-04","2022-07-19","2022-05-03","2022-07-13","2022-10-10","2022-11-02","2022-11-22"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","","CALCITRIOL","CAP 0.5MCG","","Select","Select",""],["","00536354710","DAILY-VITE","TAB ","30","Select","Select",""],["","00406012405","HYDROCO\/APAP","TAB 7.5-325","21","Select","Select",""],["","","SMZ\/TMP","TAB 800-160","","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00143962125","CYANOCOBALAM","INJ 1000MCG","1","Select","Select",""],["","24979070406","DEXLANSOPRAZ","CAP 60MG DR","30","Select","Select",""],["","80681002000","MULTIVITAMIN","TAB ","30","Select","Select",""],["","00378808245","TRETINOIN","CRE 0.00025","45","Select","Select",""],["","59762374302","CLINDAMYCIN","GEL 0.01","60","Select","Select",""],["","27241009803","DULOXETINE","CAP 30MG","30","Select","Select",""],["","11917011328","CALCIUM","","60","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","00254302902","LUBIPROSTONE","CAP 24MCG","60","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","62332000131","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","","FLUCLVX","INJ 2020-21","","Select","Select",""],["","00187516245","RETIN-A","CRE 0.0005","45","Select","Select",""],["","49884093547","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00713031788","CICLOPIROX","SOL 0.08","7","Select","Select",""],["","74312001570","MULTI-DAY","TAB ","30","Select","Select",""],["","","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","00093224001","CEPHALEXIN","TAB 500MG","20","Select","Select",""],["","31604001886","CALCIUM\/D","TAB 500-400","120","Select","Select",""],["","69238183801","LEVOTHYROXIN","TAB 150MCG","30","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","64764017530","DEXILANT","CAP 60MG DR","30","Select","Select",""],["","60505083305","AZELASTINE","SPR 0.001","30","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","11917002529","INSULIN","MIS 1ML\/30G","10","Select","Select",""],["","76385012350","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","57237000430","FLUCONAZOLE","TAB 100MG","5","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","67618010110","COLACE","CAP 100MG","60","Select","Select",""],["","","CYCLOBENZAPR","TAB 5MG","","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","21","Select","Select",""],["","","IPRATROPIUM\/","SOL ALBUTER","","Select","Select",""],["","","PREGABALIN","CAP 75MG","","Select","Select",""],["","66685100100","AMOX\/K","TAB 875-125","20","Select","Select",""],["","","DOCUSATE","CAP 100MG","","Select","Select",""],["","","STOOL","CAP 100MG","","Select","Select",""],["","51991035860","ASENAPINE","SUB 5MG","60","Select","Select",""],["","60505265301","TRAZODONE","TAB 50MG","30","Select","Select",""],["","00378623201","CITALOPRAM","TAB 20MG","30","Select","Select",""],["","16729053308","DODEX","INJ ","1","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","28","Select","Select",""],["","11917007452","MULTIPLE","TAB ","30","Select","Select",""],["","","DIAZEPAM","TAB 2MG","","Select","Select",""],["","","AMITIZA","CAP 8MCG","","Select","Select",""],["","11845007551","OYS","TAB \/VIT D","130","Select","Select",""],["","00591024105","LORAZEPAM","TAB 1MG","1","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","65862090901","CELECOXIB","CAP 200MG","30","Select","Select",""],["","00574200830","NYSTOP","POW 100000","30","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","30","Select","Select",""],["","00456240563","SAPHRIS","SUB 5MG","60","Select","Select",""],["","68462030201","INDOMETHACIN","CAP 50MG","60","Select","Select",""],["","00904645760","DOK","CAP 100MG","30","Select","Select",""],["","","BUDES\/FORMOT","AER 160-4.5","","Select","Select",""],["","57237004805","DIVALPROEX","TAB 500MG DR","30","Select","Select",""],["","62559043130","HYDROCORTISO","CRE 0.025","60","Select","Select",""],["","13811071910","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","63402030630","LATUDA","TAB 60MG","30","Select","Select",""],["","75834014712","HYDROCORT","SUP 25MG","14","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","00254100752","ALBUTEROL","AER HFA","7","Select","Select",""],["","12843053430","PHILLIPS","CAP COLON","30","Select","Select",""],["","50580072638","ZYRTEC","TAB 10MG","30","Select","Select",""],["","00093506110","HYDROXYZ","TAB 25MG","28","Select","Select",""],["","00228202996","ALPRAZOLAM","TAB 0.5MG","30","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","15","Select","Select",""],["","00574110404","BROM\/PSE\/DM","SYP ","120","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","100","Select","Select",""],["","68180016613","VANCOMYCIN","CAP 125MG","40","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","120","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","49281042150","FLUZONE","INJ 2021-22","0","Select","Select",""],["","29300013005","HYDROCHLOROT","CAP 12.5MG","30","Select","Select",""],["","31604002517","CALCIUM\/VITD","TAB 500-400","60","Select","Select",""],["","67405082508","BENZOYL","LIQ 5% WASH","237","Select","Select",""],["","00054001925","PREDNISONE","TAB 50MG","3","Select","Select",""],["","","MUCINEX","TAB 600MG ER","","Select","Select",""],["","23155013525","DOXYCYC","TAB 100MG","28","Select","Select",""],["","","OFLOXACIN","DRO 0.3% OP","","Select","Select",""],["","55111012601","CIPROFLOXACN","TAB 250MG","10","Select","Select",""],["","","EZALLOR","CAP 20MG","","Select","Select",""],["","","ROSUVASTATIN","TAB 20MG","","Select","Select",""],["","00904530760","BANOPHEN","CAP 50MG","2","Select","Select",""],["","","ASPIRIN-81","CHW 81MG","","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","5","Select","Select",""],["","55111012290","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","68382013805","TOPIRAMATE","TAB 25MG","90","Select","Select",""],["","00363051908","PAIN","TAB 500MG\/RR","30","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","60505083001","MOMETASONE","SPR 50MCG","17","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","00456120130","LINZESS","CAP 145MCG","30","Select","Select",""],["","45802057178","FEXOFENADINE","TAB 180MG","30","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","20","Select","Select",""],["","00597010061","SPIRIVA","SPR 2.5MCG","4","Select","Select",""],["","00904671960","ACETAMINOPHE","TAB 325MG","30","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","40","Select","Select",""],["","62542030117","HYD","SUS 10-8\/5ML","50","Select","Select",""],["","55111068305","IBU","TAB 600MG","40","Select","Select",""],["","69543025216","VIRTUSSIN","SOL 100-10\/5","60","Select","Select",""],["","33332031901","AFLURIA","INJ 2019-20","0","Select","Select",""],["","68462029817","CLOTRIM\/BETA","CRE DIPROP","15","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":""}]}]}