{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  ENITSENRETTENRUB E ","gend":1,"add":"TEDRUB W 13243152 TPA DR ET","city":"FRANKLIN","state":"VA","zip":"23851-9998","dob":"1960-02-20","age":"","mstatus":"","insh":"20400210*81","cliId":"","pno":"36\/7571515-3","cno":"757\/633-5151","email":"","ename":"","eno":"","pphy":"BRECKE, STEFAN F PA","ppno":"757\/539-0251","pcpadd":"2000 MEADE PARKWAY","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":23434,"pcpcounty":"","pcpid":"","pcpname":"Lakeview Internal Medicine Meade","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":["I10.","R00.2","F63.81","R45.4","F10.20","E78.5","M25.569","K21.9","Z23.","M54.5","M79.7","M51.36","M47.817","NO DATA","M70.61","K91.2","Z98.84","G47.00","M17.0","Z68.34","M21.611","M21.612","M20.41","M20.42","M77.41","M77.42","Z01.810","I51.7","I25.2","M79.672","T78.40XA","S82.832A","M96.0","I47.1","Z01.812","Z20.822","M13.842","M53.3","K63.5","R19.5","R39.81","M18.11","M18.12","S01.81XA","R51.9","R04.0","V43.52XA","Y93.89","Y92.9","Z20.828","G89.18","M18.0","M10.072","E78.1","G89.29","G62.9","R00.0","M79.642","R32.","F07.81","I47.9","M25.50","M25.561","M25.562","Z96.653","M79.641","M79.671","R92.8","Z47.89","R94.31","S92.311A","M25.571","M13.841","I25.10","G47.33","Z96.1","H26.491","M19.90","Q70.22","Z88.0","S06.0X0A","S92.314K","R52.","Z87.898","F41.9","Z68.33","M79.673","S93.144A","M19.071","M20.40","E78.2","E66.9","Z79.899","Z87.891","Z68.30","Z63.1","F10.10","R55.","H35.373","F32.9","Z01.818","R53.81","H10.45","S19.9XXA","S09.93XA","V49.9XXA"],"date":["2022-08-17","2022-07-20","2020-09-21","2020-09-21","2021-08-10","2022-05-31","2020-03-18","2022-04-20","2021-09-30","2021-01-07","2022-08-10","2022-08-10","2022-08-10","2022-09-12","2021-01-07","2021-04-28","2022-04-20","2020-04-07","2022-07-20","2020-04-07","2021-03-11","2021-05-25","2021-03-11","2021-10-07","2020-05-04","2021-05-25","2021-09-28","2021-08-31","2020-05-29","2022-09-12","2021-03-11","2021-09-28","2021-09-28","2022-07-20","2021-10-05","2021-10-05","2022-07-01","2022-08-10","2022-10-12","2022-10-12","2020-11-19","2022-08-17","2022-04-20","2020-11-13","2020-11-13","2020-11-13","2020-11-13","2020-11-13","2020-11-13","2020-11-18","2022-08-17","2022-02-14","2021-08-16","2022-05-31","2022-05-11","2022-09-12","2022-03-24","2022-07-01","2022-10-05","2021-01-19","2021-08-10","2021-04-28","2021-08-17","2021-08-17","2022-04-20","2022-08-17","2022-09-12","2020-04-21","2020-12-22","2022-03-31","2021-10-07","2021-12-06","2022-08-17","2022-08-17","2022-08-17","2022-08-23","2022-08-23","2020-02-12","2020-06-17","2022-04-20","2020-12-16","2021-10-07","2022-06-10","2020-04-23","2022-04-20","2020-04-23","2020-09-18","2021-03-11","2021-03-11","2021-09-28","2022-04-20","2022-04-20","2022-04-20","2022-04-20","2022-04-20","2020-02-07","2020-02-07","2020-02-28","2021-04-19","2021-04-28","2022-03-31","2022-05-02","2020-03-06","2020-11-13","2020-11-13","2020-11-13"],"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":[["","67877046305","PREGABALIN","CAP 50MG","60","Select","Select",""],["","43547043009","FENOFIBRATE","TAB 48MG","30","Select","Select",""],["","68180035202","SERTRALINE","TAB 50MG","30","Select","Select",""],["","51267089099","CONTRAVE","TAB 8-90MG","120","Select","Select",""],["","00054001025","FLECAINIDE","TAB 50MG","60","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","65162062750","TRAMADOL","TAB 50MG","45","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","400","Select","Select",""],["","00591252001","CHLORZOXAZON","TAB 500MG","180","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","36","Select","Select",""],["","55111046705","METOPROL","TAB 50MG ER","30","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","00832003800","OXYBUTYNIN","TAB 5MG","60","Select","Select",""],["","75826011510","PHENAZOPYRID","TAB 200MG","6","Select","Select",""],["","31722072320","LEVOFLOXACIN","TAB 750MG","7","Select","Select",""],["","70954006020","PREDNISONE","TAB 20MG","10","Select","Select",""],["","00536120215","LIDOCAINE","PAD 0.04","5","Select","Select",""],["","68084077725","ACETAMINOPHE","TAB 650MG ER","15","Select","Select",""],["","13668044201","CELECOXIB","CAP 200MG","90","Select","Select",""],["","55111064505","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","20","Select","Select",""],["","50111043303","TRAZODONE","TAB 50MG","90","Select","Select",""],["","68382013914","TOPIRAMATE","TAB 50MG","90","Select","Select",""],["","59762444002","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00536105429","ASPIRIN","TAB 325MG","56","Select","Select",""],["","49483034001","ACETAMIN","TAB 325MG","56","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","30","Select","Select",""],["","45802035653","TROLAMINE","CRE SAL 10%","85","Select","Select",""],["","31722063231","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","51991074710","DULOXETINE","CAP 30MG","30","Select","Select",""],["","13107003105","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","14","Select","Select",""],["","68462079817","TRIAMCINOLON","OIN 0.005","15","Select","Select",""],["","29300012501","MELOXICAM","TAB 15MG","90","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","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":""}]}]}