{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  ALEMAPNOXID K","gend":1,"add":"B HT11 82693 TPA DR YA","city":"NORFOLK","state":"VA","zip":23518,"dob":"1968-10-19","age":"","mstatus":"","insh":"20400210*93","cliId":"","pno":"06\/7571248-9","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"757\/583-2181","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23518,"pcpcounty":"","pcpid":"","pcpname":"BAYVIEW PHYSICIAN SERVICES PC","plan":"OHP","program":"Medicaid","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.40","Z79.4","Z68.42","J45.909","K21.9","H10.13","J30.89","J30.81","J30.1","I10.","N17.9","E66.3","E11.9","E11.8","R60.9","J30.2","Z23.","N28.9","Z12.11","Z01.419","E78.2","M25.471","M25.472","R82.90","N18.3","J02.9","J30.9","R09.81","J45.30","E11.29","E66.01","M79.672","E78.00","R80.9","F41.1","R60.0","N30.01","M25.522","F31.32","H92.03","H65.02","J45.998","J06.9","H66.93","H66.91","J01.90","M54.89","M77.12","G47.33","Z79.82","Z79.899","M25.562","K59.00","NO DATA","Z11.52","I51.7","I34.0","F31.4","R05.","R10.10","R21.","H92.01","J20.9","J01.80","F41.9","F33.0","K04.7","Z68.43","N30.00","E11.65","Z01.89","E55.9","J01.00","S80.02XA","L29.9","R07.89","R00.2","M79.605","Z20.828","B34.9","Z92.29","J32.9","Z00.00","Z12.31","E78.5","N18.9","J32.0","Z13.29","F33.1","Z76.89","J45.20","F31.62","F90.0","Z86.16","H01.005"],"date":["2022-05-18","2021-12-13","2021-01-11","2020-04-24","2021-11-15","2021-04-05","2022-10-18","2022-10-18","2022-08-23","2022-08-22","2020-10-12","2020-10-12","2020-10-12","2021-12-13","2019-05-14","2019-09-30","2022-10-10","2019-09-09","2022-08-22","2019-09-09","2022-05-18","2022-05-18","2019-09-09","2019-11-18","2020-07-06","2020-07-20","2022-08-22","2021-08-28","2022-02-14","2019-10-14","2019-02-04","2019-02-04","2019-02-04","2019-10-14","2022-05-18","2019-06-10","2019-05-20","2019-07-24","2022-11-17","2020-12-09","2019-12-16","2020-01-06","2022-06-20","2020-01-27","2021-02-03","2022-05-16","2019-05-14","2019-07-24","2019-07-24","2019-07-24","2019-07-24","2020-03-16","2020-08-10","2022-05-18","2021-09-14","2019-06-10","2019-06-10","2022-07-11","2020-07-28","2020-08-08","2020-08-21","2020-10-03","2019-12-21","2020-08-02","2022-11-17","2022-01-04","2021-12-13","2021-12-13","2019-05-14","2022-10-10","2020-01-06","2022-08-22","2022-03-25","2020-02-19","2020-06-09","2020-07-10","2020-07-15","2020-07-21","2021-08-30","2021-08-30","2022-10-18","2022-02-23","2022-08-22","2022-08-22","2022-08-22","2022-08-22","2022-08-22","2022-05-18","2022-04-25","2022-05-18","2022-05-18","2022-07-25","2022-11-17","2022-09-19","2022-11-09"],"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":[["","","EPINASTINE","DRO 0.0005","","Select","Select",""],["","","MOMETASONE"," MOMETASONE ","17","Select","Select",""],["","","TRINTELLIX"," TRINTELLIX ","30","Select","Select",""],["","","METOPROL"," METOPROL ","60","Select","Select",""],["","","MONTELUKAST"," MONTELUKAST ","10","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","","VICTOZA"," VICTOZA ","6","Select","Select",""],["","","LANTUS"," LANTUS ","15","Select","Select",""],["","","FUROSEMIDE"," FUROSEMIDE ","30","Select","Select",""],["","","NOVOLOG"," NOVOLOG ","15","Select","Select",""],["","","HYDRALAZINE"," HYDRALAZINE ","60","Select","Select",""],["","","AZELASTINE","SPR 0.001","","Select","Select",""],["","49483048112","ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","","ONETOUCH"," ONETOUCH ","100","Select","Select",""],["","00173060102","FLOVENT","AER 250MCG","60","Select","Select",""],["","","ROSUVASTATIN"," ROSUVASTATIN ","30","Select","Select",""],["","23155013525","DOXYCYC","TAB 100MG","20","Select","Select",""],["","","HYDROXYZ","TAB 10MG","","Select","Select",""],["","","LORATADINE"," LORATADINE ","90","Select","Select",""],["","","BD  PEN NEEDL"," BD  PEN NEEDL","100","Select","Select",""],["","","QVAR"," QVAR ","11","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","98302000199","COMFORT","MIS 31GX5MM","200","Select","Select",""],["","","CVS"," CVS ","30","Select","Select",""],["","","LOSARTAN\/HCT","TAB 50-12.5","","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","21","Select","Select",""],["","","FAMOTIDINE"," FAMOTIDINE ","60","Select","Select",""],["","","DOXYCYCL"," DOXYCYCL ","14","Select","Select",""],["","73070010315","INSULIN","INJ FLEXPEN","15","Select","Select",""],["","","AZITHROMYCIN"," AZITHROMYCIN ","6","Select","Select",""],["","52937000120","VASCEPA","CAP 1GM","360","Select","Select",""],["","00093598627","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","","VRAYLAR"," VRAYLAR ","30","Select","Select",""],["","","BENZONATATE","CAP 200MG","","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","75","Select","Select",""],["","00904671839","MUCUS","TAB 600MG ER","60","Select","Select",""],["","74312003849","FISH","CAP 1000MG","360","Select","Select",""],["","00054050823","ICOSAPENT","CAP 1GM","360","Select","Select",""],["","69097012203","TOPIRAMATE","TAB 25MG","30","Select","Select",""],["","49502050002","EPIPEN","INJ 0.3MG","2","Select","Select",""],["","","PNEUMOVAX","INJ 25\/0.5","","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN 5MG\/GM","4","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","68180038909","FENOFIBRATE","TAB 145MG","90","Select","Select",""],["","55111052830","ATOMOXETINE","CAP 25MG","30","Select","Select",""],["","","FLUCLVX","INJ 2020-21","","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","00169643810","LEVEMIR","INJ FLEXTOUC","15","Select","Select",""],["","50428047857","EYE","DRO 0.025%OP","10","Select","Select",""],["","49281042150","FLUZONE","INJ 2021-22","0","Select","Select",""],["","60505100301","KETOROLAC","SOL 0.005","5","Select","Select",""],["","00002882427","HUMULIN","INJ U-500","6","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","57896022110","ACETAMIN","TAB 500MG","30","Select","Select",""],["","","CLINDAMYCIN","CAP 300MG","","Select","Select",""],["","31722070090","LOSARTAN","TAB 25MG","60","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","","ACID","TAB 20MG","","Select","Select",""],["","00065427325","PAZEO","DRO 0.007","2","Select","Select",""],["","","HYDROCO\/APAP","TAB 7.5-325","","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","","TRIAMCINOLON","CRE 0.005","","Select","Select",""],["","","MAG","SOL CHERRY","","Select","Select",""],["","","PERMETHRIN","CRE 0.05","","Select","Select",""],["","","PREVNAR","INJ ","","Select","Select",""],["","24208063562","NEO\/POLY\/HC","SUS 1% OTIC","10","Select","Select",""],["","","FLONASE","SUS 27.5MCG","","Select","Select",""],["","","PROMETH\/COD","SOL 6.25-10","","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}